Individual
KIMBERLY FENELON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
135 S WALDINGER ST, VALLEY STREAM, NY 11580-5217
(917) 371-5028
Mailing address
135 S WALDINGER ST, VALLEY STREAM, NY 11580-5217
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
721598
NY
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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