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NPI Code Detail

MEDICARE: JENNIFER AGHAVIAN

MEDICARE: JENNIFER AGHAVIAN
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1417730110
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER AGHAVIAN
Provider Business Mailing Address
First Line : 120 W 97TH ST APT 2F
Second Line :
City : NEW YORK
State : NY
Zip : 10025-6451
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 365 WILLOUGHBY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-5191
Country : US
Telephone Number : 718-875-6900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2023
Last Update Date : 08/16/2023

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Directions to “ JENNIFER AGHAVIAN ” Practice Location

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