Provider Demographics
NPI:1245456243
Name:HORNING, JENNIFER YVETTE (PA)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:YVETTE
Last Name:HORNING
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:318 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1905
Mailing Address - Country:US
Mailing Address - Phone:516-837-8573
Mailing Address - Fax:
Practice Address - Street 1:1650 SELWYN AVE APT 11F
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7663
Practice Address - Country:US
Practice Address - Phone:718-960-1334
Practice Address - Fax:718-960-2071
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYP44165363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant