Provider Demographics
NPI:1235802869
Name:DORSAINVIL, JESSICA (FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:
Last Name:DORSAINVIL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1811
Mailing Address - Country:US
Mailing Address - Phone:347-329-4010
Mailing Address - Fax:347-329-4009
Practice Address - Street 1:359 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1811
Practice Address - Country:US
Practice Address - Phone:347-329-4010
Practice Address - Fax:347-329-4009
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347963363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner