Provider Demographics
NPI:1780088377
Name:HENNESSY, JESSIE SARAH (NP)
Entity type:Individual
Prefix:MRS
First Name:JESSIE
Middle Name:SARAH
Last Name:HENNESSY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:SARAH
Other - Last Name:HILLSBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1275 YORK AVE
Mailing Address - Street 2:PEDIATRIC DAY HOSPITAL -9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:212-639-5952
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:PEDIATRIC DAY HOSPITAL -9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-5952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF382466-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics