Provider Demographics
NPI:1881024719
Name:JEAN, RITA ESTHER (RN)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:ESTHER
Last Name:JEAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 09 28 STREET
Mailing Address - Street 2:CN25
Mailing Address - City:LIC
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:42 09 28 STREET
Practice Address - Street 2:CN25
Practice Address - City:LIC
Practice Address - State:NY
Practice Address - Zip Code:11101-4130
Practice Address - Country:US
Practice Address - Phone:917-807-0386
Practice Address - Fax:347-396-4565
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY458217-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool