Individual
LYNNETTE JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
200 WINSTON DR APT 718, CLIFFSIDE PK, NJ 07010-3214
(201) 888-0573
(718) 233-9688
Mailing address
200 WINSTON DR APT 718, CLIFFSIDE PK, NJ 07010-3214
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
004683
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
320028878
NBCOT
NJ
Enumeration date
07/24/2009
Last updated
07/24/2009
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