National Provider Identifier

Jennifer Tess Fenwick, ATC

Jennifer Tess Fenwick, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (631) 204-7988.

NPI 1578207312Ithaca, NYAthletic Trainer

Profile Overview

NPI
1578207312
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
April 27, 2022
Last Updated
April 27, 2022

Practice Location

  • 512 N Campus
  • Ithaca, NY 14853-6007

Phone: (631) 204-7988

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1578207312
Entity Type
Individual
Last Name
Fenwick
First Name
Jennifer
Middle Name
Tess
Credential
ATC
Mailing Street Address
512 N Campus
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14853-6007
Mailing Country
US
Practice Street Address
512 N Campus
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14853-6007
Practice Country
US
Practice Phone
(631) 204-7988
Enumeration Date
April 27, 2022
Last Updated
April 27, 2022
Sex
Female
Sole Proprietor
No
Certification Date
April 27, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)