Individual
JENNIFER HA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 BROADWAY STE 5, HEWLETT, NY 11557-1600
(516) 514-7840
Mailing address
1705 BROADWAY STE 5, HEWLETT, NY 11557-1600
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
060119
NY
Other
Enumeration date
02/15/2017
Last updated
09/02/2021
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