Provider Demographics
NPI:1659820645
Name:BARNETT, JOLENE ALICIA (MSED)
Entity Type:Individual
Prefix:MRS
First Name:JOLENE
Middle Name:ALICIA
Last Name:BARNETT
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3464 WILSON AVE
Mailing Address - Street 2:APT 4B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2326
Mailing Address - Country:US
Mailing Address - Phone:347-981-3669
Mailing Address - Fax:
Practice Address - Street 1:3464 WILSON AVE
Practice Address - Street 2:APT 4B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2326
Practice Address - Country:US
Practice Address - Phone:347-981-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist