MEDICARE: JENNIFER L. NEY, D.O. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1174645451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER L. NEY, D.O. INC.

Provider Business Mailing Address
First Line	:	1417 KADERLY ST NW
Second Line	:
City	:	NEW PHILADELPHIA
State	:	OH
Zip	:	44663-1242
Country	:	US
Telephone Number	:	330-602-2656
Fax Number	:	330-602-2657

Provider Business Practice Location Address
First Line	:	1417 KADERLY ST NW
Second Line	:
City	:	NEW PHILADELPHIA
State	:	OH
Zip	:	44663-1242
Country	:	US
Telephone Number	:	330-602-2656
Fax Number	:	330-602-2657

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JENNIFER LYNN NEY
Credential	:	D.O.
Telephone Number	:	330-602-2656

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	11/01/2007

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