Provider Demographics
NPI:1730657602
Name:WRIGHT, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 N BROADWAY STE 106
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1315
Mailing Address - Country:US
Mailing Address - Phone:917-942-8825
Mailing Address - Fax:917-979-8170
Practice Address - Street 1:800 POLY PL # 11
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-630-3730
Practice Address - Fax:718-630-2970
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341480-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily