Provider Demographics
NPI:1902089733
Name:GINES, VERONICA MENESES (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:MENESES
Last Name:GINES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9746 91ST ST # 2C
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-2211
Mailing Address - Country:US
Mailing Address - Phone:718-529-5124
Mailing Address - Fax:
Practice Address - Street 1:525 ROCKAWAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3100
Practice Address - Country:US
Practice Address - Phone:718-240-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-15
Last Update Date:2007-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303262363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner