Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 056544-1 | NY |
NPI | 1083874333 |
---|---|
Provider Name | Dr. Jennifer Lynn Henkin |
First Address | New York, NY 10032-1565 |
Second Address | New York, NY 10035-4003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 12/12/2013 |