MEDICARE: JENN JILL FAMILY INC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1528990926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENN JILL FAMILY INC

Provider Business Mailing Address
First Line	:	6439 98TH ST APT 4C
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-3306
Country	:	US
Telephone Number	:	202-908-4891
Fax Number	:

Provider Business Practice Location Address
First Line	:	6439 98TH ST APT 4C
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-3306
Country	:	US
Telephone Number	:	202-908-4891
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MADONA KARSADZE
Credential	:
Telephone Number	:	202-908-4891

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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