Individual
JENNA EIVAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1530 FRONT ST, EAST MEADOW, NY 11554-2265
(516) 324-7500
Mailing address
343 LEXINGTON AVE, WEST HEMPSTEAD, NY 11552-1320
(516) 477-7811
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004927
NY
Other
Enumeration date
02/26/2025
Last updated
12/03/2025
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