Provider Demographics
NPI:1710772504
Name:JAMAL, JENNIFER (RDN, CDN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:JAMAL
Suffix:
Gender:
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:CONTRONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, CDN
Mailing Address - Street 1:55 JESMERAL CT
Mailing Address - Street 2:
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547-1458
Mailing Address - Country:US
Mailing Address - Phone:914-224-1614
Mailing Address - Fax:
Practice Address - Street 1:55 JESMERAL CT
Practice Address - Street 2:
Practice Address - City:MOHEGAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:10547-1458
Practice Address - Country:US
Practice Address - Phone:914-224-1614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered