Provider Demographics
NPI:1538658679
Name:FELICIANO-BERMEJO, JASMINE (RN)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:FELICIANO-BERMEJO
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 1:4801 8TH AVE # 3R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2213
Mailing Address - Country:US
Mailing Address - Phone:347-791-5859
Mailing Address - Fax:
Practice Address - Street 1:4801 8TH AVE # 3R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2213
Practice Address - Country:US
Practice Address - Phone:347-791-5859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY541771-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse