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General NPI Number Information
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NPI Number | 1558442467
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Entity Type | Individual
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Provider Name | JENNIFER CONCEPCION ANP
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 1 PENN PLZ SUITE 725
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City | NEW YORK
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State | NY
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Zip | 10119-0002
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Country | US
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Telephone | 631-929-0060
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Fax | 212-216-6606
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Provider Business Mailing Address
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Address Line | 1 PENN PLZ SUITE 725
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City | NEW YORK
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State | NY
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Zip | 10119-0002
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Country | US
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Telephone | 631-929-0060
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Fax | 212-216-6606
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F302444
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License Number State | NY
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