MEDICARE: JENNIFER ANN SCIMONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	606034	NY
2	163W00000X	Registered Nurse	26NR25268000	NJ
3	163WS0200X	School Registered Nurse	606034	NY

General Provider Information

NPI Number	:	1184307050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ANN SCIMONE

Provider Business Mailing Address
First Line	:	162 STROUD AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3244
Country	:	US
Telephone Number	:	347-681-0844
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 47TH AVE FL 7
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3433
Country	:	US
Telephone Number	:	347-515-2252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	08/08/2023

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Directions to “ JENNIFER ANN SCIMONE ” Practice Location

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