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General NPI Number Information
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NPI Number | 1669915203
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Entity Type | Individual
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Provider Name | ANNETTE JARRETT-GRAHAM FNP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 55 BROAD ST
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City | NEW YORK
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State | NY
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Zip | 10004-2501
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Country | US
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Telephone | 347-761-3105
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Fax |
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Provider Business Mailing Address
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Address Line | 8 MICHAEL F ST
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City | LOCUST VALLEY
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State | NY
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Zip | 11560-1232
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Country | US
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Telephone | 917-559-2923
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 340714
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 403590
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License Number State | NY
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