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NPI Code Detail

MEDICARE: JENNY WAMELING

MEDICARE:   JENNY  WAMELING
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
1252Y00000XEarly Intervention Provider Agency519930041NY

General Provider Information

NPI Number : 1861896490
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY WAMELING
Provider Business Mailing Address
First Line : 48 ARLINGTON TER
Second Line :
City : UTICA
State : NY
Zip : 13501-6424
Country : US
Telephone Number : 315-404-6049
Fax Number :
Provider Business Practice Location Address
First Line : 19 ROBINSON RD
Second Line :
City : CLINTON
State : NY
Zip : 13323-1418
Country : US
Telephone Number : 315-853-6104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2014
Last Update Date : 10/10/2014

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Directions to “ JENNY WAMELING ” Practice Location

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