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General NPI Number Information
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NPI Number | 1285267971
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Entity Type | Individual
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Provider Name | JESSICA LEONORA NAVARRETTE NP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 2001 MARCUS AVE STE W290
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1098
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Country | US
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Telephone | 516-465-5255
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Fax | 718-347-2240
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Provider Business Mailing Address
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Address Line | 2155 SALISBURY PARK DR
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City | WESTBURY
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State | NY
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Zip | 11590-6313
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Country | US
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Telephone | 516-526-5875
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 382713
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License Number State | NY
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