Provider Demographics
NPI:1386090710
Name:THOMPSON, JAMILA EFIA (FNP)
Entity type:Individual
Prefix:
First Name:JAMILA
Middle Name:EFIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141K MANORHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1555
Mailing Address - Country:US
Mailing Address - Phone:646-596-4853
Mailing Address - Fax:
Practice Address - Street 1:979 CROSS BRONX EXPY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460
Practice Address - Country:US
Practice Address - Phone:718-665-7565
Practice Address - Fax:347-226-4092
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF339939-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily