1346504669 NPI number — MRS. JENNIFER PERLETTE DOSSETT LMT

Table of content: MRS. JENNIFER PERLETTE DOSSETT LMT (NPI 1346504669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346504669 NPI number — MRS. JENNIFER PERLETTE DOSSETT LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOSSETT
Provider First Name:
JENNIFER
Provider Middle Name:
PERLETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PERLETTE
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346504669
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 WINDCREST DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHEEKTOWAGA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14225-2520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-510-2550
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3648 SENECA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST SENECA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14224-3400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-771-1354
Provider Business Practice Location Address Fax Number:
716-771-1562
Provider Enumeration Date:
07/02/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  024965 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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