Provider Demographics
NPI:1134295975
Name:BILLINGTON, JENIFFER (CNM)
Entity type:Individual
Prefix:MRS
First Name:JENIFFER
Middle Name:
Last Name:BILLINGTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5925 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-5009
Mailing Address - Country:US
Mailing Address - Phone:718-972-2700
Mailing Address - Fax:718-972-2701
Practice Address - Street 1:5925 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5009
Practice Address - Country:US
Practice Address - Phone:718-972-2700
Practice Address - Fax:718-972-2701
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF0012021367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYO3228291Medicaid