MEDICARE: MRS. JENNIFER THERESA DIPIAZZA-SILEO NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F400941	NY

General Provider Information

NPI Number	:	1154545069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER THERESA DIPIAZZA-SILEO NP

Provider Business Mailing Address
First Line	:	23946 OAK PARK DR
Second Line	:
City	:	DOUGLASTON
State	:	NY
Zip	:	11362-2612
Country	:	US
Telephone Number	:	212-443-1157
Fax Number	:

Provider Business Practice Location Address
First Line	:	726 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-9502
Country	:	US
Telephone Number	:	718-281-0644
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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