Provider Demographics
NPI:1538439898
Name:WAJNGOLD, JENNIFER LINDSAY (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LINDSAY
Last Name:WAJNGOLD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E 58TH ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1236
Mailing Address - Country:US
Mailing Address - Phone:212-980-3600
Mailing Address - Fax:212-980-5863
Practice Address - Street 1:133 E 58TH ST
Practice Address - Street 2:SUITE 1201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1236
Practice Address - Country:US
Practice Address - Phone:212-980-3600
Practice Address - Fax:212-980-5863
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ034471-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist