Provider Demographics
NPI:1316144991
Name:KAMINSTEIN, JENNIFER LIDDELL (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LIDDELL
Last Name:KAMINSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:YOUNG
Other - Last Name:LIDDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:16 MANOR AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17551-1132
Mailing Address - Country:US
Mailing Address - Phone:717-872-5444
Mailing Address - Fax:
Practice Address - Street 1:16 MANOR AVE STE A
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17551-1132
Practice Address - Country:US
Practice Address - Phone:717-872-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD444470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine