Basic Information
| Provider Information | |||||||||
| NPI: | 1053653816 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JCH REGISTERED NURSE SERVICES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 306 GOLD ST APT 32A | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112013051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328890868 | ||||||||
| FaxNumber: | 7328895167 | ||||||||
| Practice Location | |||||||||
| Address1: | 577 PROSPECT AVE BSMT SUITE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112156065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183691444 | ||||||||
| FaxNumber: | 7183693066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2013 | ||||||||
| LastUpdateDate: | 10/09/2018 | ||||||||
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| AuthorizedOfficialLastName: | HARVEY | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | CORETTA | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7328990868 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.