Basic Information
| Provider Information | |||||||||
| NPI: | 1316446289 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRAUSS | ||||||||
| FirstName: | JENNA | ||||||||
| MiddleName: | BROOKE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 428 POE AVE | ||||||||
| Address2: | |||||||||
| City: | WESTFIELD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070902729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9085780830 | ||||||||
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| Practice Location | |||||||||
| Address1: | 350 E 17TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100033805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124202000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2018 | ||||||||
| LastUpdateDate: | 02/06/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.