Individual
JIHANE REAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
380 WASHINGTON AVE, ROOSEVELT, NY 11575-1845
(516) 378-2000
Mailing address
2789 1ST PL, BALDWIN, NY 11510-4029
(646) 377-7418
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F339249
NY
363LF0000X
Family Nurse Practitioner
F339249-1
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
F339249
NY
Other
Enumeration date
07/08/2016
Last updated
10/11/2016
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