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NPI Code Detail

MEDICARE: JENNIFER NOLAN ED.M.

MEDICARE: JENNIFER NOLAN ED.M.
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
1103TS0200XSchool Psychologist1020901NY

General Provider Information

NPI Number : 1497057327
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER NOLAN ED.M.
Provider Business Mailing Address
First Line : 1825 BATH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-4613
Country : US
Telephone Number : 718-238-4637
Fax Number :
Provider Business Practice Location Address
First Line : 1825 BATH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-4613
Country : US
Telephone Number : 718-238-4637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2010
Last Update Date : 11/29/2010

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