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General NPI Number Information
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NPI Number | 1790309060
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Entity Type | Individual
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Provider Name | JENNIFER ELAINE LEGORE
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Gender | Female
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 06/03/2020
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Provider Practice Location Address
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Address Line | 822 CARTERET AVE
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City | TRENTON
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State | NJ
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Zip | 08618-5310
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Country | US
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Telephone | 609-954-1876
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Fax | 609-228-6342
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Provider Business Mailing Address
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Address Line | 3 RONIT DR
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City | EWING
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State | NJ
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Zip | 08628-2225
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Country | US
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Telephone | 609-954-1876
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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