Provider Demographics
NPI:1376378307
Name:SCANNELL, YESENIA
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:SCANNELL
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 1:704 LENOX RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1449
Mailing Address - Country:US
Mailing Address - Phone:201-696-0514
Mailing Address - Fax:
Practice Address - Street 1:704 LENOX RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1449
Practice Address - Country:US
Practice Address - Phone:201-696-0514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY913142163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse