Provider Demographics
NPI:1396166237
Name:CRAYNER-ARYEE, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CRAYNER-ARYEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2094 STANLEY TER
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4312
Mailing Address - Country:US
Mailing Address - Phone:973-652-2451
Mailing Address - Fax:973-923-8993
Practice Address - Street 1:271 GROVE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1730
Practice Address - Country:US
Practice Address - Phone:973-239-1513
Practice Address - Fax:973-239-0482
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00472400363LA2200X, 363LF0000X
NY308911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health