Provider Demographics
NPI:1902084080
Name:DEFILIPPIS, JEANETTE ANN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:ANN
Last Name:DEFILIPPIS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:BOX 1228
Mailing Address - Street 2:ONE GUSTAVE L LEVY PLACE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-2612
Mailing Address - Fax:212-987-5683
Practice Address - Street 1:ONE GUSTAVE L LEVY PLACE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-2612
Practice Address - Fax:212-987-5683
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400527363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner