Provider Demographics
NPI:1730535469
Name:SUBRIN, JENNIFER HOPE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HOPE
Last Name:SUBRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 HAMBLEN FARM RD
Mailing Address - Street 2:
Mailing Address - City:WELLFLEET
Mailing Address - State:MA
Mailing Address - Zip Code:02667-7311
Mailing Address - Country:US
Mailing Address - Phone:917-535-9124
Mailing Address - Fax:
Practice Address - Street 1:40 HAMBLEN FARM RD
Practice Address - Street 2:
Practice Address - City:WELLFLEET
Practice Address - State:MA
Practice Address - Zip Code:02667-7311
Practice Address - Country:US
Practice Address - Phone:917-535-9124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program