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General NPI Number Information
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NPI Number | 1083053714
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Entity Type | Individual
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Provider Name | DR. JENNIFER DINEEN
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Gender | Female
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Dates
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Enumeration Date | 06/16/2013
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Last Update Date | 06/16/2013
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Provider Practice Location Address
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Address Line | ST. VINCENTS UNIVERSITY HOSPITAL DEPARTMENT OF NEUROLOGY
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City | DUBLIN
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State | 0
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Zip | 4
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Country | IE
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Telephone | 86-837-9119
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MANOR GROVE, BLACKWATER
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City | CLARE
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State | 0
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Zip | 0
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Country | IE
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 255061
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License Number State | MA
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