Jessica Marie Mennella, AGPCNP-C
Nurse Practitioner, Adult Health in New Hyde Park, NY. Individual provider (NPI-1).
NPI number1043676471
StatusActive
Last updated in NPPESNov 10, 2017
Details
- NPI
- 1043676471
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jessica Marie Mennella
- Credential
- AGPCNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 14, 2016
- Last updated
- Nov 10, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2200X | Nurse Practitioner, Adult Health | 307519 | NY | Yes |
| 363LG0600X | Nurse Practitioner, Gerontology | 307519 | NY |
Practice location
1991 Marcus AveNew Hyde Park, NY 11042-2057
Phone 516-354-1600 · Fax 516-941-4677
Mailing address
55 Water St Fl 12New York, NY 10041-0004
Phone 646-680-2888 · Fax 516-542-5556
Other practice locations
1991 Marcus Ave
New Hyde Park, NY 11042-2057
New Hyde Park, NY 11042-2057
Phone 646-680-4081
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