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General NPI Number Information
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NPI Number | 1558819698
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Entity Type | Individual
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Provider Name | JENNIFER AMANDA RATTRAY RN
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Gender | Female
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 09/19/2016
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Provider Practice Location Address
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Address Line | 107 W 4TH ST
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City | MOUNT VERNON
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State | NY
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Zip | 10550-4002
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Country | US
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Telephone | 914-699-7200
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Fax | 914-699-4259
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Provider Business Mailing Address
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Address Line | 2288 BAYLIS AVE
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City | ELMONT
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State | NY
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Zip | 11003-2807
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Country | US
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Telephone | 516-850-5226
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 722802-1
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License Number State | NY
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