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General NPI Number Information
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NPI Number | 1861315178
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Entity Type | Individual
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Provider Name | GINA JENNINGS
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 518 MONTAUK HWY
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City | AMAGANSETT
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State | NY
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Zip | 11930-2110
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Country | US
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Telephone | 631-717-7684
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Fax |
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Provider Business Mailing Address
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Address Line | 40 MONROE DR
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City | MONTAUK
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State | NY
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Zip | 11954-5146
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Country | US
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Telephone | 516-312-9330
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 002706
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License Number State | NY
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