Provider Demographics
NPI:1396149621
Name:ENCARNACION, JANETY
Entity type:Individual
Prefix:
First Name:JANETY
Middle Name:
Last Name:ENCARNACION
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 1:51 SUNFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-7127
Mailing Address - Country:US
Mailing Address - Phone:845-632-2168
Mailing Address - Fax:
Practice Address - Street 1:51 SUNFLOWER CIR
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-7127
Practice Address - Country:US
Practice Address - Phone:845-632-2168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist