Individual
MS. JEAN MARIE ODOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
342 BEACH 54TH ST, ARVERNE, NY 11692-1782
(718) 634-5448
Mailing address
342 BEACH 54TH ST, ARVERNE, NY 11692-1782
(718) 634-5448
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
303085
NY
Other
Enumeration date
09/06/2007
Last updated
06/01/2022
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