Individual
MAGDELIN JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18709 LINDEN BLVD, JAMAICA, NY 11412-4025
(718) 500-5549
Mailing address
18709 LINDEN BLVD, JAMAICA, NY 11412-4025
(718) 500-5549
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6462036868
—
NY
Enumeration date
08/29/2022
Last updated
08/29/2022
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