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Individual

MISS KIMBERLY L JENKINS I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
226 BEACH 98TH ST # 3, ROCKAWAY PARK, NY 11694-2849
(718) 569-0508
(833) 318-2363
Mailing address
226 BEACH 98TH ST # 3, ROCKAWAY PARK, NY 11694-2849
(718) 569-0508
(833) 318-2363

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
00483595
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00483595
NY
Enumeration date
04/24/2019
Last updated
04/24/2019
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