Jennifer Rose Gorenfeld, PT

Individual provider Active NPI Early Intervention Provider Agency · Katonah, NY

NPI 1659517316 · NPPES record last updated Apr 21, 2015

Key facts

NPI
1659517316
Entity type
Individual (NPI type 1)
Primary specialty
Early Intervention Provider Agency 252Y00000X
License
PT024991 (NY)
Practice address
29 Wildwood Rd
Katonah, NY 10536-1708
Phone
(917) 576-0376
NPI assigned
Dec 31, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT024991NYMDEarly Intervention Provider Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X PT024991 NY Yes

Addresses

Primary practice location

29 Wildwood Rd
Katonah, NY 10536-1708

Mailing address

29 Wildwood Rd
Katonah, NY 10536-1708
Phone (917) 576-0376

Other providers in Katonah, NY

All providers in Katonah, NY · Early Intervention Provider Agency in New York

Sources for this page

Verify at the official NPI Registry.