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General NPI Number Information
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NPI Number | 1609202258
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Entity Type | Individual
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Provider Name | JENNIFER KATHLEEN SHIH
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Gender | Female
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Dates
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Enumeration Date | 09/15/2013
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Last Update Date | 10/26/2013
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Provider Practice Location Address
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Address Line | 14015 SANFORD AVE STE B
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City | FLUSHING
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State | NY
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Zip | 11355-2688
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Country | US
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Telephone | 909-569-9325
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Fax |
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Provider Business Mailing Address
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Address Line | 4514 80TH ST FL 1
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City | ELMHURST
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State | NY
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Zip | 11373-3550
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Country | US
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 090229-1
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License Number State | NY
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