Provider Demographics
NPI:1437918356
Name:HATAMOVA, JENNET (RN)
Entity Type:Individual
Prefix:
First Name:JENNET
Middle Name:
Last Name:HATAMOVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JENNET
Other - Middle Name:
Other - Last Name:HATAMOVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1230 AVENUE X APT 4P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4228
Mailing Address - Country:US
Mailing Address - Phone:917-855-2552
Mailing Address - Fax:
Practice Address - Street 1:1230 AVENUE X APT 4P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4228
Practice Address - Country:US
Practice Address - Phone:917-855-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY758523-01163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient