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General NPI Number Information
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NPI Number | 1396697132
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Entity Type | Individual
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Provider Name | KEVIN ALBERTO JIMENEZ
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Gender | Male
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 110 E 40TH ST RM 803
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City | NEW YORK
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State | NY
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Zip | 10016-1800
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Country | US
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Telephone | 888-722-2072
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Fax |
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Provider Business Mailing Address
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Address Line | 2602 4TH ST APT 3F
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City | ASTORIA
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State | NY
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Zip | 11102-4889
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Country | US
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Telephone | 845-820-2323
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 834863
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License Number State | NY
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