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General NPI Number Information
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NPI Number | 1447702840
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Entity Type | Organization
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Legal Business Name | CAROLE JENKS
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Dates
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Enumeration Date | 11/01/2016
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 248 STATE ST APT 1F.
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City | ALBANY
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State | NY
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Zip | 12210-2132
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Country | US
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Telephone | 518-621-6626
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Fax |
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Provider Business Mailing Address
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Address Line | 248 STATE ST APT 1F.
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City | ALBANY
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State | NY
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Zip | 12210-2132
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Country | US
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Telephone | 518-621-6626
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | CAROLE ANN JENKS
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Credential | LPN
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Telephone | 518-621-6626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 324373-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 324373-1
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License Number State | NY
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