Healthcare Provider Details
I. General information
NPI: 1053653816
Provider Name (Legal Business Name): JCH REGISTERED NURSE SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2013
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
577 PROSPECT AVE BSMT SUITE
BROOKLYN NY
11215-6065
US
IV. Provider business mailing address
306 GOLD ST APT 32A
BROOKLYN NY
11201-3051
US
V. Phone/Fax
- Phone: 718-369-1444
- Fax: 718-369-3066
- Phone: 732-889-0868
- Fax: 732-889-5167
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
JENNIFER
CORETTA
HARVEY
Title or Position: PRESIDENT/OWNER
Credential: CRNA
Phone: 732-899-0868