Individual
JENNIFER GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8000 YORK RD, TOWSON UNIVERSITY, TOWSON, MD 21252-0001
(516) 491-1596
Mailing address
200 CENTRAL AVE, LYNBROOK, NY 11563-1407
(516) 491-1596
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
934859507
NY
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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