Provider Demographics
NPI:1063897148
Name:FRENKEL, FENYA
Entity type:Individual
Prefix:
First Name:FENYA
Middle Name:
Last Name:FRENKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2083 E 65TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5913
Mailing Address - Country:US
Mailing Address - Phone:718-444-5105
Mailing Address - Fax:718-444-5106
Practice Address - Street 1:2083 E 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5913
Practice Address - Country:US
Practice Address - Phone:718-444-5105
Practice Address - Fax:718-444-5106
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily