=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851176929
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J.J. D'ORAZIO, INTEGRATIVE PSYCHIATRIC, N.P., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2023
-----------------------------------------------------
Last Update Date | 09/05/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 350 CENTRAL PARK W APT 1C
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10025-8842
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-405-0775
-----------------------------------------------------
Fax | 646-918-6263
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 808 COLUMBUS AVE APT 17E
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10025-5162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-405-0775
-----------------------------------------------------
Fax | 646-918-6263
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NURSE PRACTITIONER
-----------------------------------------------------
Name | DR. JENNIFER JENNINGS D'ORAZIO
-----------------------------------------------------
Credential | DNP
-----------------------------------------------------
Telephone | 917-405-0775
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------