Provider Demographics
NPI:1669073045
Name:BHATTI, JENNIPHER SARWAR (CASE MANAGER)
Entity type:Individual
Prefix:
First Name:JENNIPHER
Middle Name:SARWAR
Last Name:BHATTI
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:MS
Other - First Name:JENNIPHER
Other - Middle Name:SARWAR
Other - Last Name:BHATTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CASE MANAGER
Mailing Address - Street 1:4 LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1222
Mailing Address - Country:US
Mailing Address - Phone:914-663-7070
Mailing Address - Fax:
Practice Address - Street 1:19-20 149TH STREET #R WHITESTONE
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357
Practice Address - Country:US
Practice Address - Phone:516-780-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NY106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator