Individual
JESSICA MORDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
25715 148TH DR, ROSEDALE, NY 11422-3018
(347) 869-3595
Mailing address
25715 148TH DR, ROSEDALE, NY 11422-3018
(347) 869-3595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
626663
NY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
F421255-1
NY
Other
Enumeration date
12/13/2012
Last updated
12/19/2019
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