Provider Demographics
NPI:1801452859
Name:INFANTE, JASMINE RAE
Entity type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:RAE
Last Name:INFANTE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JASMINE
Other - Middle Name:RAE
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1738
Mailing Address - Country:US
Mailing Address - Phone:646-637-1912
Mailing Address - Fax:
Practice Address - Street 1:8115 251ST ST
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2525
Practice Address - Country:US
Practice Address - Phone:646-637-1912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY762045163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse