Bagen, Jenny T.

Bagen, Jenny T. is an sole proprietor health care provider with primary practice located at 1405 Sheridan Dr , Tonawanda NY 14217-1248. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Bagen, Jenny T. can be contacted via phone (716) 432-2892.

Contact Information

Primary practice address
1405 Sheridan Dr Tonawanda NY 14217-1248
Phone: (716) 432-2892
Fax: (716) 389-4155
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X F400997 New York
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X F400997-1 New York

Profile Details

NPI number 1184647505
LBN Legal business name Bagen, Jenny T.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2006
Last updated Feb 3rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184647505 NPPES
New York MEDICAID 02792363

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