Provider Demographics
NPI:1073957544
Name:AMING, JEANEAN GERSHA (NP)
Entity Type:Individual
Prefix:
First Name:JEANEAN
Middle Name:GERSHA
Last Name:AMING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4223
Mailing Address - Country:US
Mailing Address - Phone:845-380-2450
Mailing Address - Fax:845-486-4055
Practice Address - Street 1:900 ROUTE 376, SUITE H
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLLS
Practice Address - State:NY
Practice Address - Zip Code:12601-4223
Practice Address - Country:US
Practice Address - Phone:845-204-9260
Practice Address - Fax:845-204-9260
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340938363LF0000X
NY579876163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty