Wiley, Jennifer Grace
Wiley, Jennifer Grace is an sole proprietor health care provider with primary practice located at 10 Center St , Lake Ronkonkoma NY 11779-4524. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Wiley, Jennifer Grace can be contacted via phone (631) 428-3508.Contact Information
Primary practice address
10 Center St
Lake Ronkonkoma NY 11779-4524
Phone: (631) 428-3508
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 899067 | New York |
Profile Details
| NPI number | 1821351602 |
|---|---|
| LBN Legal business name | Wiley, Jennifer Grace |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 18th, 2012 |
| Last updated | Jun 18th, 2012 - about 12 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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