Provider Demographics
NPI:1922379221
Name:FAMIGHETTI, JENNIFER FRANCES (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:FRANCES
Last Name:FAMIGHETTI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3837
Mailing Address - Country:US
Mailing Address - Phone:516-558-7612
Mailing Address - Fax:
Practice Address - Street 1:387 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3837
Practice Address - Country:US
Practice Address - Phone:516-558-7612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275307164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse