Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | F350514 | NY |
NPI | 1114513611 |
---|---|
Provider Name | Jennifer Hutkoff |
First Address | Edgewater, NJ 07020-1664 |
Second Address | New York, NY 10016-9196 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2020 |
Last Update Date | 18/12/2020 |