Provider Demographics
NPI:1659656742
Name:BARRESI, JENNIFER GRACE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GRACE
Last Name:BARRESI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BONTICOU VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1004
Mailing Address - Country:US
Mailing Address - Phone:518-859-4783
Mailing Address - Fax:
Practice Address - Street 1:222 ROUTE 299
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2524
Practice Address - Country:US
Practice Address - Phone:845-691-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily