Healthcare Provider Details

I. General information

NPI: 1568708824
Provider Name (Legal Business Name): JENNIFER GARIB FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER GARIB FNP

II. Dates (important events)

Enumeration Date: 12/13/2012
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 EAST 22ND STREET
BROOKLYN NY
11210
US

IV. Provider business mailing address

629 E 22ND ST
BROOKLYN NY
11210-1101
US

V. Phone/Fax

Practice location:
  • Phone: 917-804-3705
  • Fax:
Mailing address:
  • Phone: 917-804-3705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number824073
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number353385
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number353385
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11035015
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number824073
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number353385
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number353385
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: