Provider Demographics
NPI:1467909663
Name:IHRIG, JEAN (MS,ED)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:IHRIG
Suffix:
Gender:F
Credentials:MS,ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 LIVINGSTON ST
Mailing Address - Street 2:2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5021
Mailing Address - Country:US
Mailing Address - Phone:347-453-8680
Mailing Address - Fax:
Practice Address - Street 1:88 LIVINGSTON ST
Practice Address - Street 2:2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5021
Practice Address - Country:US
Practice Address - Phone:347-453-8680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY779031971174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist