Provider Demographics
NPI:1487031555
Name:GAMEZ, JESSICA STEPHANIE (RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:STEPHANIE
Last Name:GAMEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E 137TH ST APT 11I
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-4222
Mailing Address - Country:US
Mailing Address - Phone:718-585-0111
Mailing Address - Fax:
Practice Address - Street 1:81 OCEAN PKWY APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1763
Practice Address - Country:US
Practice Address - Phone:917-975-4081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY698564163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics