Provider Demographics
NPI:1316359979
Name:ALAMO, JHANINE LOUREN (PA-C)
Entity type:Individual
Prefix:MS
First Name:JHANINE
Middle Name:LOUREN
Last Name:ALAMO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7901 BROADWAY # D6-19
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-2772
Mailing Address - Fax:718-334-5006
Practice Address - Street 1:7901 BROADWAY # D6-19
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2772
Practice Address - Fax:718-334-5006
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017558363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant