Provider Demographics
NPI:1033960836
Name:MEERE, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MEERE
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 1:97 JONI DR
Mailing Address - Street 2:
Mailing Address - City:WEST SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11796-1014
Mailing Address - Country:US
Mailing Address - Phone:631-553-9996
Mailing Address - Fax:
Practice Address - Street 1:97 JONI DR
Practice Address - Street 2:
Practice Address - City:WEST SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11796-1014
Practice Address - Country:US
Practice Address - Phone:631-553-9996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-11-06
Deactivation Date:2024-09-28
Deactivation Code:
Reactivation Date:2024-10-07
Provider Licenses
StateLicense IDTaxonomies
NY355180363LF0000X
NY797107163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse