Jenifer Natalie Clemente
Individual provider Active NPI General Practice Registered Nurse · Shirley, NY
NPI 1053044941 · NPPES record last updated Jul 7, 2022
Key facts
- NPI
- 1053044941
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Registered Nurse 163WG0000X
- License
- 459617 (NY)
- Practice address
- 485 Lockwood Dr
Shirley, NY 11967-1117 - Phone
- (631) 806-4181
- NPI assigned
- Jul 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 459617 | NY | MD | General Practice Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 459617 | NY | Yes |
Addresses
Primary practice location
485 Lockwood Dr
Shirley, NY 11967-1117
Mailing address
485 Lockwood Dr
Shirely, NY 11967
Phone (631) 806-4181
Other providers in Shirley, NY
- Christian Ciarlo
- Dawn Marie Cidoni
- City Medical of Upper East Side, PLLC
- Virginia Cleary
- Christina Denise Clemente
- Rowan Cohen-McKiernan
- Adam Daniel Cohen
- Harris Roger Cohen
- Kathleen M Collins
- Daneen Colombo
All providers in Shirley, NY · General Practice Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.