| Doctor Name: | MRS. JENNIFER LYNN BATES |
| NPI Number: | 1639311228 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 692963 |
| Business Practice Address: | 452 Camby Rd Verbank, NY - 125855304 |
| Business Phone Number: | 8456770031 |
| Business Fax Number: | |
| Mailing Address: | 1110 Route 55, LAGRANGEVILLE |
| State: | NY |
| Postal Code: | 125405045 |
| Phone Number: | 8454738445 |
| Fax Number: | |
| NPI Enumeration Date: | 03/30/2009 |
| NPI Last Update Date: | 03/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1744P3200X |
| License Number: | 692963 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | Prosthetics Case Management |
| Taxonomy Definition: | |