Organization
JENNA MEDICAL OFFICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNA L BUTNER MD (PRESIDENT)
(516) 721-6717
Entity
Organization
Contact information
Practice address
13405 ROCKAWAY BLVD, SOUTH OZONE PARK, NY 11420-3020
(718) 323-9700
Mailing address
235 E 44TH ST APT 9D, NEW YORK, NY 10017-4384
(516) 721-6717
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
270676
NY
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
04/02/2016
Last updated
09/21/2021
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