Provider Demographics
NPI:1285066035
Name:JIMENEZ, KARINA AILEEN
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:AILEEN
Last Name:JIMENEZ
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 1:1222 ASTORIA BLVD APT 4B
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-4982
Mailing Address - Country:US
Mailing Address - Phone:917-741-7784
Mailing Address - Fax:
Practice Address - Street 1:765 SOUTHERN BLVD
Practice Address - Street 2:#5D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-2138
Practice Address - Country:US
Practice Address - Phone:917-741-7784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-04
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker