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General NPI Number Information
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NPI Number | 1942854534
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Entity Type | Individual
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Provider Name | JINETTE HENRIUS REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 16937 144TH RD
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City | JAMAICA
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State | NY
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Zip | 11434-5929
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Country | US
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Telephone | 718-978-7221
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Fax | 718-978-0032
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Provider Business Mailing Address
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Address Line | 266 W VALLEY STREAM BLVD
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City | VALLEY STREAM
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State | NY
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Zip | 11580-5341
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Country | US
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Telephone | 516-643-8038
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 767589-1
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License Number State | NY
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