Provider Demographics
NPI:1164952198
Name:JAYSON, SVETLANA (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:
Last Name:JAYSON
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1115
Mailing Address - Country:US
Mailing Address - Phone:732-382-9700
Mailing Address - Fax:732-382-9707
Practice Address - Street 1:152 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1115
Practice Address - Country:US
Practice Address - Phone:732-382-9700
Practice Address - Fax:732-382-9707
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00733100363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology