MEDICARE: MRS. JENNIFER ALICIA AQUINO ARNP

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	363LF0000X	Family Nurse Practitioner	F339023-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F339023-1	OTHER	NY	NYC LICENSE

General Provider Information

NPI Number	:	1285077636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER ALICIA AQUINO ARNP

Provider Business Mailing Address
First Line	:	150 E 42ND ST FL 9
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-5699
Country	:	US
Telephone Number	:	646-605-8186
Fax Number	:

Provider Business Practice Location Address
First Line	:	2771 FREDERICK DOUGLASS BLVD
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10039-3027
Country	:	US
Telephone Number	:	212-690-0303
Fax Number	:	212-636-3000

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

Provider Enumeration Date	:	04/15/2013
Last Update Date	:	08/03/2020

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