Jenna Marie Candemeres, CPNP-PC
Nurse Practitioner, Pediatrics in Port Jefferson Station, NY. Individual provider (NPI-1).
NPI number1932965688
StatusActive
Last updated in NPPESFeb 21, 2024
Details
- NPI
- 1932965688
- Entity type
- Individual (NPI-1)
- Name
- Jenna Marie Candemeres
- Credential
- CPNP-PC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 21, 2024
- Certification date
- Feb 21, 2024
- Last updated
- Feb 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 383487 | NY | Yes |
Practice location
112 Terryville RdPort Jefferson Station, NY 11776-1329
Phone 631-209-2827
Mailing address
38 Ferraro DrHolbrook, NY 11741-5320
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