Provider Demographics
NPI:1639716566
Name:POURNARAS, JESSICA M (CD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:POURNARAS
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 E 26TH ST APT 3K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2161
Mailing Address - Country:US
Mailing Address - Phone:646-385-2297
Mailing Address - Fax:
Practice Address - Street 1:645 E 26TH ST APT 3K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2161
Practice Address - Country:US
Practice Address - Phone:646-385-2297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula