Provider Demographics
NPI:1750175675
Name:JEAN, KENSY (DC,MSACN)
Entity type:Individual
Prefix:DR
First Name:KENSY
Middle Name:
Last Name:JEAN
Suffix:
Gender:
Credentials:DC,MSACN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 ROLLINSON ST
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4520
Mailing Address - Country:US
Mailing Address - Phone:973-393-1249
Mailing Address - Fax:
Practice Address - Street 1:494 PROSPECT AVE # 4112
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4112
Practice Address - Country:US
Practice Address - Phone:973-736-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00812400111N00000X, 111NR0400X, 111NS0005X, 111NN1001X
133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No133N00000XDietary & Nutritional Service ProvidersNutritionist