Provider Demographics
NPI:1114218252
Name:ABREU, JESSICA M (RN)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:M
Last Name:ABREU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 TERRACE CIR
Mailing Address - Street 2:APARTMENT 1D
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4169
Mailing Address - Country:US
Mailing Address - Phone:347-421-3801
Mailing Address - Fax:
Practice Address - Street 1:11 TERRACE CIR
Practice Address - Street 2:APARTMENT 1D
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4169
Practice Address - Country:US
Practice Address - Phone:347-421-3801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-24
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028184363LP0808X
NY640322163W00000X
CA95184980163W00000X
NY405400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse