Jerominow, Larissa

Jerominow, Larissa is an sole proprietor health care provider with primary practice located at 4771 Hylan Blvd , Staten Island NY 10312-6315. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Jerominow, Larissa can be contacted via phone (718) 948-8200.

Contact Information

Primary practice address
4771 Hylan Blvd Staten Island NY 10312-6315
Phone: (718) 948-8200
Fax: (718) 420-2718
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X F30911-01 New York
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X F309311-01 New York

Profile Details

NPI number 1285284992
LBN Legal business name Jerominow, Larissa
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2019
Last updated Oct 5th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285284992 NPPES
Other 1205559812 NURSE PRACTITIONER-ADULT GERONTOLOGY

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