Provider Demographics
NPI:1851891642
Name:INZERILLO, JANET ANN
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ANN
Last Name:INZERILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:JOST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 PEAR CT
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2143
Mailing Address - Country:US
Mailing Address - Phone:631-767-0146
Mailing Address - Fax:
Practice Address - Street 1:1 PEAR CT
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2143
Practice Address - Country:US
Practice Address - Phone:631-767-0146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-18
Last Update Date:2018-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY574272-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse