Kelly Jensen

NPI #1548645245 in Selden, New York

Provider Information

NPI Number: 1548645245
Entity Type: Individual
Name: Kelly Jensen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Jul 23, 2015
Last Updated: Jul 23, 2015

Practice Location

Address: 19 MALLARD AVE
City: Selden
State: New York
ZIP Code: 11784-2309
Phone: (631) 579-0705

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X
Specialist	174400000X	Primary

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