Provider Demographics
NPI:1720280050
Name:BYRNES, JENNIFER HELAINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HELAINE
Last Name:BYRNES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 MARCUS AVE
Mailing Address - Street 2:SUITE C-119
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1038
Mailing Address - Country:US
Mailing Address - Phone:516-390-3525
Mailing Address - Fax:516-396-2195
Practice Address - Street 1:1981 MARCUS AVE
Practice Address - Street 2:SUITE C-119
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1038
Practice Address - Country:US
Practice Address - Phone:516-390-3525
Practice Address - Fax:516-396-2195
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015609103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical