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General NPI Number Information
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NPI Number | 1659717387
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Entity Type | Individual
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Provider Name | JEANNA MASONE ANP
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Gender | Female
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 05/21/2013
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Provider Practice Location Address
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Address Line | 129 EVERGREEN LN
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-5805
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Country | US
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Telephone | 631-903-0150
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Fax |
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Provider Business Mailing Address
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Address Line | 100 PORT WASHINGTON BOULEVARD ST. FRANCIS HOSPITAL
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City | ROSLYN
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State | NY
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Zip | 11576-1348
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Country | US
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Telephone | 516-562-6000
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Fax | 516-562-6797
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F306210-1
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License Number State | NY
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