Provider Demographics
NPI:1730201591
Name:ZADEL, JANIS LEE (NP)
Entity type:Individual
Prefix:MS
First Name:JANIS
Middle Name:LEE
Last Name:ZADEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:79 PLEASANT WAY
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3122
Mailing Address - Country:US
Mailing Address - Phone:973-746-0696
Mailing Address - Fax:212-305-7692
Practice Address - Street 1:743-749 EAST 9TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009
Practice Address - Country:US
Practice Address - Phone:212-677-7999
Practice Address - Fax:212-739-0007
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF300185-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health