Tomasiewicz, Jenna Nicole

Tomasiewicz, Jenna Nicole is an individual health care provider with primary practice located at 24 Chimney Dr , Bethel CT 06801-1225. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Tomasiewicz, Jenna Nicole can be contacted via phone (845) 905-6564.

Contact Information

Primary practice address
24 Chimney Dr Bethel CT 06801-1225
Phone: (845) 905-6564
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 103149 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 4373 Connecticut

Profile Details

NPI number 1902449341
LBN Legal business name Tomasiewicz, Jenna Nicole
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2019
Last updated Oct 18th, 2023 - about 3 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 1902449341 NPPES
New York Other 1497737167 AGENCY NPI
New York MEDICAID 02995857 AGENCY NPI

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