Individual
JENNIFER EFFIE AMENGUAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 731-5196
Mailing address
630 W 168TH ST, BOX 4, NEW YORK, NY 10032-3725
(212) 731-5196
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
244419
NY
207RH0003X
Hematology & Oncology Physician
244419
NY
207RX0202X
Medical Oncology Physician
Primary
244419
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03252444
—
NY
Enumeration date
06/20/2007
Last updated
06/05/2023
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