Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 054316 | CT |
N | 208000000X | Pediatrician | 248854 | NY |
N | 2080A0000X | Adolescent Medicine | 54316 | CT |
NPI | 1114188240 |
---|---|
Provider Name | Dr. Jennifer S Wilner |
First Address | West Hartford, CT 06119-1673 |
Second Address | West Hartford, CT 06119-1673 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2008 |
Last Update Date | 09/11/2016 |