Provider Demographics
NPI:1568609436
Name:IRIZARRY, JENNIFER M (PA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:IRIZARRY
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:3765 RIVERDALE AVE
Mailing Address - Street 2:SUITE #7
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1845
Mailing Address - Country:US
Mailing Address - Phone:718-549-1086
Mailing Address - Fax:718-884-4885
Practice Address - Street 1:3765 RIVERDALE AVE
Practice Address - Street 2:SUITE #7
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1845
Practice Address - Country:US
Practice Address - Phone:718-549-1086
Practice Address - Fax:718-884-4885
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical