Provider Demographics
NPI:1265014435
Name:INEZ, JANINE (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:INEZ
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 PINEHURST AVE APT E6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1846
Mailing Address - Country:US
Mailing Address - Phone:347-737-1612
Mailing Address - Fax:
Practice Address - Street 1:286 5TH AVE FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4559
Practice Address - Country:US
Practice Address - Phone:347-737-1612
Practice Address - Fax:408-538-3702
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY801787163W00000X
NY404231363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse