Basic Information
| Provider Information | |||||||||
| NPI: | 1962506105 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOS SANTOS | ||||||||
| FirstName: | JEANNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | FNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MARINHO | ||||||||
| OtherFirstName: | JEANNE | ||||||||
| OtherMiddleName: | DOS SANTOS | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | FNP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 22 SAW MILL RIVER RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | HAWTHORNE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105321533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9145931659 | ||||||||
| FaxNumber: | 9145931790 | ||||||||
| Practice Location | |||||||||
| Address1: | 755 N BROADWAY | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SLEEPY HOLLOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105911075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143663400 | ||||||||
| FaxNumber: | 9143663407 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2006 | ||||||||
| LastUpdateDate: | 03/21/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 334284 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.