Provider Demographics
NPI:1831481209
Name:SAFERSTEIN, JENNIFER BETH (LAC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BETH
Last Name:SAFERSTEIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 N CLEVELAND MASSILLON RD STE 10
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2185
Mailing Address - Country:US
Mailing Address - Phone:330-576-4144
Mailing Address - Fax:
Practice Address - Street 1:843 N CLEVELAND MASSILLON RD STE 10
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-2185
Practice Address - Country:US
Practice Address - Phone:330-576-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004443-1171100000X
OH000322171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist