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General NPI Number Information
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NPI Number | 1841877883
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Entity Type | Individual
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Provider Name | JESSICA LAGUERRE
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Gender | Female
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 10201 66TH RD
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City | FOREST HILLS
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State | NY
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Zip | 11375-2029
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Country | US
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Telephone | 718-830-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 OCEAN AVE APT 404
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City | BROOKLYN
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State | NY
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Zip | 11230-2046
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Country | US
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Telephone | 347-301-6743
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 421442
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License Number State | NY
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