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General NPI Number Information
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NPI Number | 1760531040
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Entity Type | Individual
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Provider Name | HANNA JESIONOWSKA MD
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 159 E 74TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-3249
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Country | US
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Telephone | 212-794-0080
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Fax | 212-744-5506
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Provider Business Mailing Address
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Address Line | 179 E 79TH ST APT. 16A
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City | NEW YORK
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State | NY
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Zip | 10021-0467
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Country | US
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Telephone | 917-470-5911
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Fax | 212-744-5506
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 167170
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License Number State | NY
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