Healthcare Provider Details
I. General information
NPI: 1841073558
Provider Name (Legal Business Name): JENNIFER FRANJUL
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4419 3RD AVE
BRONX NY
10457-2562
US
IV. Provider business mailing address
1065 SOUTHERN BLVD
BRONX NY
10459-2417
US
V. Phone/Fax
- Phone: 718-364-7700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | P110306 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: