Provider Demographics
NPI:1932411162
Name:LENNON, JAMELIA (RN)
Entity Type:Individual
Prefix:
First Name:JAMELIA
Middle Name:
Last Name:LENNON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 FTELEY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-1401
Mailing Address - Country:US
Mailing Address - Phone:718-866-8485
Mailing Address - Fax:
Practice Address - Street 1:1401 FTELEY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-1401
Practice Address - Country:US
Practice Address - Phone:718-866-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY622261163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse