Individual
JEANIQUE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 470-7310
Mailing address
12111 196TH ST # 2, SPRINGFIELD GARDENS, NY 11413-1138
(617) 201-4696
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
814550
NY
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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