Provider Demographics
NPI:1417636002
Name:PATRICIA R JANSON NP PC
Entity Type:Organization
Organization Name:PATRICIA R JANSON NP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-224-2204
Mailing Address - Street 1:100 MANETTO HILL RD STE 307
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1311
Mailing Address - Country:US
Mailing Address - Phone:917-224-2204
Mailing Address - Fax:646-219-4358
Practice Address - Street 1:100 MANETTO HILL RD STE 307
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1311
Practice Address - Country:US
Practice Address - Phone:917-224-2204
Practice Address - Fax:646-219-4358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty