Provider Demographics
NPI:1750904777
Name:ALCANTARA, JUEMELY (FNP)
Entity type:Individual
Prefix:MS
First Name:JUEMELY
Middle Name:
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 AUTUMN CIR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1605
Mailing Address - Country:US
Mailing Address - Phone:914-473-0527
Mailing Address - Fax:
Practice Address - Street 1:12 AUTUMN CIR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-1605
Practice Address - Country:US
Practice Address - Phone:914-473-0527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345790363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily