Individual
MS. JENNY T. BAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1405 SHERIDAN DR, TONAWANDA, NY 14217-1248
(716) 432-2892
(716) 389-4155
Mailing address
1405 SHERIDAN DR, TONAWANDA, NY 14217-1248
(716) 432-2892
(716) 389-4155
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F400997
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400997-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02792363
—
NY
Enumeration date
07/26/2006
Last updated
02/03/2019
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