MEDICARE: JALESSE A MUNOZ ANP, NP-C

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	363LA2200X	Adult Health Nurse Practitioner	26NJ00855800	NJ

General Provider Information

NPI Number	:	1255808697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JALESSE A MUNOZ ANP, NP-C

Provider Business Mailing Address
First Line	:	3540 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-3450
Country	:	US
Telephone Number	:	551-353-2053
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-3450
Country	:	US
Telephone Number	:	551-353-2053
Fax Number	:

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

Provider Enumeration Date	:	10/24/2018
Last Update Date	:	11/05/2025

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