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NPI Code Detail

MEDICARE: MRS. JENNIFER MURRAY BUONOCORE MS, OTR/L

MEDICARE: MRS. JENNIFER MURRAY BUONOCORE MS, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171W00000XContractor011735-1NY

General Provider Information

NPI Number : 1063666865
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER MURRAY BUONOCORE MS, OTR/L
Provider Business Mailing Address
First Line : 1259 MARA CT
Second Line :
City : ATLANTIC BEACH
State : NY
Zip : 11509-1635
Country : US
Telephone Number : 516-431-1688
Fax Number :
Provider Business Practice Location Address
First Line : 310 NATIONAL BLVD
Second Line :
City : LONG BEACH
State : NY
Zip : 11561-3326
Country : US
Telephone Number : 516-431-2929
Fax Number : 516-431-6278
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2008
Last Update Date : 06/13/2012

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