Provider Demographics
NPI:1588243471
Name:JCG NP - ADULT HEALTH
Entity type:Organization
Organization Name:JCG NP - ADULT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:JEAN-CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-216-0462
Mailing Address - Street 1:8 SECORA RD APT JS
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3727
Mailing Address - Country:US
Mailing Address - Phone:845-216-0462
Mailing Address - Fax:
Practice Address - Street 1:133 E 58TH ST STE 811
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1299
Practice Address - Country:US
Practice Address - Phone:845-216-0462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty