Provider Demographics
NPI:1184761314
Name:HUYETT, JEFFREY WAYNE (APRN, BC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:WAYNE
Last Name:HUYETT
Suffix:
Gender:M
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335 10TH ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-6909
Mailing Address - Country:US
Mailing Address - Phone:646-263-9137
Mailing Address - Fax:
Practice Address - Street 1:420 W 23RD ST
Practice Address - Street 2:SUITE PB
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2172
Practice Address - Country:US
Practice Address - Phone:212-242-6500
Practice Address - Fax:212-242-3111
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302506363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health