Individual
JENNY ETIENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHA
Contact information
Practice address
16812 127TH AVE, JAMAICA, NY 11434-3152
(917) 600-9618
Mailing address
PO BOX 70030, BROOKLYN, NY 11207-0030
(917) 600-9618
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
00319300
NY
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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