# JILLENE MYRNELLE BRATHWAITE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1174753743
- **Gender:** F
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 254046 | NY | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 254046 | NY | Yes |
| 208M00000X | Hospitalist Physician | 254046 | NY | — |

## Other

- **Enumeration date:** 07/17/2009
- **Last updated:** 07/05/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03128012 | — | NY |