Healthcare Provider Details

I. General information

NPI: 1194673749
Provider Name (Legal Business Name): TENIKA MARIE JIMENEZ CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1587 CARROLL ST APT 4B
BROOKLYN NY
11213-5402
US

IV. Provider business mailing address

1587 CARROLL ST APT 4B
BROOKLYN NY
11213-5402
US

V. Phone/Fax

Practice location:
  • Phone: 332-293-4447
  • Fax:
Mailing address:
  • Phone: 332-293-4447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNY00500773E
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: