Provider Demographics
NPI:1215182365
Name:CHRISTENSEN, JENNIFER M
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:CHRISTENSEN
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 1:54 OAKLAND VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CUDDEBACKVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12729-5118
Mailing Address - Country:US
Mailing Address - Phone:845-649-6216
Mailing Address - Fax:
Practice Address - Street 1:181 GUINEA HILL RD
Practice Address - Street 2:
Practice Address - City:SLATE HILL
Practice Address - State:NY
Practice Address - Zip Code:10973-4341
Practice Address - Country:US
Practice Address - Phone:845-355-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006494224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant