Basic Information
| Provider Information | |||||||||
| NPI: | 1609129477 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHN | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | CR NA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CATHARINE ST | ||||||||
| Address2: | P.O. BOX 550 | ||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126013100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457902661 | ||||||||
| FaxNumber: | 8457902675 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 E 14TH ST | ||||||||
| Address2: | NEW YORK EYE & EAR INFIRMARY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100034201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129794000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2012 | ||||||||
| LastUpdateDate: | 10/18/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 615916-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.