Individual
JENNIFER LYNN KANGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1184 5TH AVE, 8TH FLOOR, NEW YORK, NY 10029-6503
(212) 241-6934
Mailing address
535 W 110TH ST, APT. 10F, NEW YORK, NY 10025-2086
(212) 600-0062
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
248019
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2007
Last updated
01/30/2012
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