Individual
KATHY JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-2793
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7275
(603) 893-8886
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
72081
MA
2080P0202X
Pediatric Cardiology Physician
Primary
72081
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508016
—
NY
05
—
300006034
—
NH
05
—
3114520
—
MA
01
—
604501
HARVARD PILGRIM
MA
01
—
7500149
UNITED HEALTHCARE MA
MA
01
—
7613741
MEDICAID NC
NC
01
—
99085901
NETWORK HEALTH
MA
01
—
B20216801
CIGNA MA
MA
01
—
J14168
BCBS MA
MA
05
—
KJ03671
—
RI
Enumeration date
10/31/2005
Last updated
11/18/2020
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