JENNA MEDICAL OFFICE PC (NPI# 1811350242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811350242 |
| Entity Type | Organization |
| Organization Name | JENNA MEDICAL OFFICE PC |
| Practice Address |
2742 Third Avenue Bronx NY 10455 |
| Mailing Address |
511 47th Ave Apartment 3h Long Island City NY 11101-5722 |
| Practice Telephone | 3475776500 |
| Practice Fax Number | 3476851921 |
| Mailing Telephone | (516) 721-6717 |
| Mailing Fax Number | 7188897422 |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2017-08-04 |
| Authorized Official Name | DR. JENNA L BUTNER (PRESIDENT) |
| Authorized Official Telephone | 5167216717 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
270676 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
2742 THIRD AVENUE |
| City | BRONX |
| State | NY |
| Zip Code | 10455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946331 | Nutrished Dietitian Nutrition Solutions, P.C. | Dietitian, Registered | 2825 Third Ave Suite #301, Bronx, NY 10455 | 2020-09-15 |
| 1538641907 | Michelle Flores | Pharmacy Technician | 754 E 151 St, Bronx, NY 10455 | 2018-09-03 |
| 1669973285 | Uhc Adult Day Program & Transportation Services, Inc | Non-emergency Medical Transport (VAN) | 368, East 149th Street Suite 3a, Bronx, NY 10455 | 2018-02-28 |
| 1578061206 | Ursula Ma Stafford | Case Management | 391 East 149 St, Suite 417, Bronx, NY 10455 | 2018-01-29 |
| 1942714506 | Chantal J George | Case Manager/Care Coordinator | 391 East 149th Street, 417, Bronx, NY 10455 | 2017-11-18 |
| 1598295800 | Sonrisa Corp | Pharmacy | 755b East 149th St, Bronx, NY 10455 | 2017-06-19 |
| 1962931378 | Josepjh Appau | Licensed Practical Nurse | 512 Jackson Avenue, Apt 2a, Bronx, NY 10455 | 2017-06-08 |
| 1295187664 | Leticia Robles | Social Worker | 480 Concord Avenue Apt#3j, Bronx, NY 10455 | 2016-07-08 |
| 1841656857 | Heracles Medical PC | Internal Medicine | 2825 Third Ave, Suite 7, Bronx, NY 10455 | 2016-01-06 |
| 1629440888 | Samaritan Daytop Village, Inc. | Clinic/Center | 2780 3rd Avenue, Bronx, NY 10455 | 2015-10-28 |
| Find all providers in zip 10455 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174716690 | Maribel Garcia-soto | Family Medicine | 1276 Fulton Ave, 3rd Floor, Bronx, NY 10456-3402 | 2007-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921957 | Titan Primary Care, Inc | Family Medicine | 3753 90th St Ste 11, Jackson Heights, NY 11372-7879 | 2020-08-05 |
| 1205467842 | Tara Healthcare LLC | Family Medicine | 157 Bleecker St # 1, New York, NY 10012-1625 | 2020-02-03 |
| 1548820608 | Cs Medical Associates, P.C. | Family Medicine | 727 N Broadway Ste B1, Massapequa, NY 11758-2348 | 2019-06-19 |
| 1992210231 | Cs Medical Associates, PC | Family Medicine | 100 Granny Road, Suite 2, Farmingville, NY 11738 | 2017-12-08 |
| 1881120376 | Yonina Mar | Family Medicine | 10 Nathan D. Perlman Pl, Msbi Psychiatry, Bernstein Pavilion, Room 7b15, New York, NY 10003 | 2017-05-03 |
| 1457771842 | Gary Demara | Family Medicine | 220 Tom Miller Rd, Plattsburgh, NY 12901-6427 | 2014-04-24 |
| 1144540022 | Michael James Reardon | Family Medicine | 41 Dunlop Rd, Huntington, NY 11743-3932 | 2010-06-02 |
| 1710123963 | Fred William Marcus | Family Medicine | 770 Jericho Tpke, Syosset, NY 11791-4516 | 2008-12-17 |
| 1740447101 | Bernard Charles Borkowski | Family Medicine | 2025 Kenneth Rd, Merrick, NY 11566-5508 | 2008-05-21 |
| 1023280740 | Charles Pouponneau | Family Medicine | 147-20 Archer Avenue, Jamaica, NY 11435 | 2008-04-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.