Provider Demographics
NPI:1093398836
Name:ARROYO, JENNIFERTA (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFERTA
Middle Name:
Last Name:ARROYO
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 1:800 COMMUNITY DR STE 206
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3821
Mailing Address - Country:US
Mailing Address - Phone:516-403-9104
Mailing Address - Fax:
Practice Address - Street 1:800 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3822
Practice Address - Country:US
Practice Address - Phone:516-403-9104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily