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NPI Code Detail

MEDICARE: JENNIFER C. VINCENT P.A.

MEDICARE:   JENNIFER C. VINCENT  P.A.
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
1363A00000XPhysician Assistant007190NY

General Provider Information

NPI Number : 1912902701
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER C. VINCENT P.A.
Provider Business Mailing Address
First Line : 2900 WESTCHESTER AVE
Second Line : STE 307
City : PURCHASE
State : NY
Zip : 10577-2551
Country : US
Telephone Number : 914-249-7000
Fax Number : 914-249-7032
Provider Business Practice Location Address
First Line : 1500 ASTOR AVE
Second Line : LBBY 1E
City : BRONX
State : NY
Zip : 10469-5900
Country : US
Telephone Number : 718-652-0003
Fax Number : 718-652-0815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 07/08/2007

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Directions to “ JENNIFER C. VINCENT P.A.” Practice Location

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