MEDICARE: MS. JENNIFER BLAISE CINELLI N.P.

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	363LF0000X	Family Nurse Practitioner	F340479-1	NY

General Provider Information

NPI Number	:	1538520051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER BLAISE CINELLI N.P.

Provider Business Mailing Address
First Line	:	1217 GEORGETOWN CT
Second Line	:
City	:	FAIRBORN
State	:	OH
Zip	:	45324-6007
Country	:	US
Telephone Number	:	917-892-7218
Fax Number	:

Provider Business Practice Location Address
First Line	:	3737 PARK EAST DR STE 220
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4347
Country	:	US
Telephone Number	:	440-368-6868
Fax Number	:	440-368-6866

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

Provider Enumeration Date	:	03/10/2016
Last Update Date	:	02/03/2025

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