Jennifer Cavallaro, FNP-C
Nurse Practitioner, Family in North Syracuse, NY. Individual provider (NPI-1).
NPI number1053972034
StatusActive
Last updated in NPPESJun 21, 2019
Details
- NPI
- 1053972034
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Cavallaro
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 21, 2019
- Last updated
- Jun 21, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 344596 | NY | Yes |
Practice location
792 N Main St Ste 100bNorth Syracuse, NY 13212-1661
Phone 315-458-4623
Mailing address
792 N Main St Ste 100bNorth Syracuse, NY 13212-1661
Phone 315-458-4623
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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