Provider Demographics
NPI:1992685986
Name:AZOR, JEAN PHILIPPE (LPN)
Entity type:Individual
Prefix:
First Name:JEAN PHILIPPE
Middle Name:
Last Name:AZOR
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 W BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11953-1815
Mailing Address - Country:US
Mailing Address - Phone:929-250-9473
Mailing Address - Fax:
Practice Address - Street 1:142 W BARTLETT RD
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-1815
Practice Address - Country:US
Practice Address - Phone:929-250-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349840164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse