Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 275214 | NY |
NPI | 1013017375 |
---|---|
Provider Name | Dr. Jens Ingemann Jensen |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |