Provider Demographics
NPI:1427859735
Name:ABDELDAYEM, JANEEN MARIE
Entity type:Individual
Prefix:
First Name:JANEEN
Middle Name:MARIE
Last Name:ABDELDAYEM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 RUSSEK DR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1641
Mailing Address - Country:US
Mailing Address - Phone:347-308-3475
Mailing Address - Fax:
Practice Address - Street 1:122 RUSSEK DR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-1641
Practice Address - Country:US
Practice Address - Phone:347-308-3475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY773006363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily