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NPI Code Detail

MEDICARE: JESSICA CERULLI RN, FNP

MEDICARE: JESSICA CERULLI RN, FNP
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
1163WX0200XOncology Registered Nurse555147NY

General Provider Information

NPI Number : 1235401985
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CERULLI RN, FNP
Provider Business Mailing Address
First Line : 946 79TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-2614
Country : US
Telephone Number : 917-282-8206
Fax Number :
Provider Business Practice Location Address
First Line : 1275 YORK AVE
Second Line : M14
City : NEW YORK
State : NY
Zip : 10065-6007
Country : US
Telephone Number : 212-639-6946
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2012
Last Update Date : 01/27/2012

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