Provider Demographics
NPI:1457198046
Name:HERNANDEZ BELTRE, JENNIFER M (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:HERNANDEZ BELTRE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 HAMMERSLEY AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3144
Mailing Address - Country:US
Mailing Address - Phone:917-930-2471
Mailing Address - Fax:
Practice Address - Street 1:1262 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-3541
Practice Address - Country:US
Practice Address - Phone:718-569-7929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY885470-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse