Individual provider Active NPI

Jeanette Obeng

  • Administrator Registered Nurse
  • Bronx, NY
National Provider Identifier
1003765660
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
965429 Issued in NY
Practice address
120 Alcott PL
Bronx, NY 10475-4201
Phone
(917) 825-7399
NPI assigned
Jan 27, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 965429 NY Primary

Addresses

Primary practice location

120 Alcott PL
Bronx, NY 10475-4201

Mailing address

120 Alcott PL
Bronx, NY 10475-4201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
965429NYMDAdministrator Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1003765660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 ALCOTT PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ALCOTT PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754201",
            "telephone_number": "917-825-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENG",
        "first_name": "JEANETTE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NY",
            "license": "965429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.