| Doctor Name: | JENNIFER ANNE ZETHNER |
| NPI Number: | 1003115528 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN,MS,PNP |
| License Number: | F381350-1 |
| Business Practice Address: | 220 Fort Salonga Rd Suite 101 Northport, NY - 117683900 |
| Business Phone Number: | 6312628505 |
| Business Fax Number: | 6317542909 |
| Mailing Address: | 112 Adams St, CENTERPORT |
| State: | NY |
| Postal Code: | 117211036 |
| Phone Number: | 6314273001 |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2011 |
| NPI Last Update Date: | 03/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | F381350-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |