Provider Demographics
NPI:1730462540
Name:BELLANTESE, JENNIFER ALLISON (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ALLISON
Last Name:BELLANTESE
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ALLISON
Other - Last Name:UZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPAC
Mailing Address - Street 1:266 DEVOE AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-2710
Mailing Address - Country:US
Mailing Address - Phone:914-645-2759
Mailing Address - Fax:212-318-4897
Practice Address - Street 1:900 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROOSEVELT ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10044-0066
Practice Address - Country:US
Practice Address - Phone:212-848-6000
Practice Address - Fax:212-318-4897
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006935363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant