Provider Demographics
NPI:1053078998
Name:JENKINS, JOSHUA BENJAMIN (MS PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:BENJAMIN
Last Name:JENKINS
Suffix:
Gender:M
Credentials:MS PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1275 DELAWARE AVE STE B100
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2412
Mailing Address - Country:US
Mailing Address - Phone:716-817-0234
Mailing Address - Fax:716-219-0708
Practice Address - Street 1:1275 DELAWARE AVE STE B100
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2412
Practice Address - Country:US
Practice Address - Phone:716-817-0234
Practice Address - Fax:716-219-0708
Is Sole Proprietor?:No
Enumeration Date:2021-11-28
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY703978163W00000X
NYF404935-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse