Provider Demographics
NPI:1902289051
Name:ALLEYNE, JERRI
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:
Last Name:ALLEYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 PARK PL APT 8
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4424
Mailing Address - Country:US
Mailing Address - Phone:718-666-7013
Mailing Address - Fax:
Practice Address - Street 1:1625 PARK PL APT 8
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-4424
Practice Address - Country:US
Practice Address - Phone:718-666-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316724-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse