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General NPI Number Information
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NPI Number | 1497468334
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Entity Type | Organization
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Legal Business Name | NYU LAGONE HEALTH
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 462 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-9196
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Country | US
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Telephone | 732-910-2953
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Fax |
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Provider Business Mailing Address
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Address Line | 34 FLAGSTONE DR
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City | PORT READING
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State | NJ
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Zip | 07064-1210
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Country | US
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Telephone | 732-910-2953
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JEANETTE JIMENEZ
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Credential | DNP, AGACNP-BC
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Telephone | 732-910-2953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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