Individual
MRS. JENNIFER SUSAN GORELOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 E 66TH ST, NEW YORK, NY 10065-6800
(646) 888-4842
Mailing address
300 E 66TH ST, NEW YORK, NY 10065-6800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN2265971
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
F307275
NY
Other
Enumeration date
09/09/2014
Last updated
03/03/2016
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