Individual
DR. MARVIN EEVAN JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3307 HUNTER AVE, APT 1, BRONX, NY 10475-1543
(718) 676-5262
Mailing address
3307 HUNTER AVE, APT 1, BRONX, NY 10475-1543
(718) 676-5262
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
N004966-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01281429
—
NY
Enumeration date
02/27/2006
Last updated
07/09/2007
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