JALYOUNG JOE (NPI# 1548676000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548676000 |
| Entity Type | Individual |
| Full Name | JALYOUNG JOE |
| Practice Address |
330 Brookline Ave # Baker5 Boston MA 02215 |
| Mailing Address |
330 Brookline Ave # Baker5 Boston MA 02215-5491 |
| Practice Telephone | 6176328930 |
| Enumeration Date | 2014-07-06 |
| Last Update Date | 2019-04-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MT205945 | PA | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD463734 | PA | Allopathic & Osteopathic Physicians |
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
274348 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5501 Old York Rd, Philadelphia, PA 191413018 | 2154568520 |
| Street Address |
330 BROOKLINE AVE # BAKER5 |
| City | BOSTON |
| State | MA |
| Zip Code | 02215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746775 | Lee T Gernon-lakin | Physician Assistant | 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 | 2020-10-08 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1538783089 | Yutsz Cherng | Counselor | 870r Commonwealth Avenue, Boston, MA 02215 | 2020-06-01 |
| 1306495924 | Anthony Rosellini | Psychologist | 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 | 2019-09-06 |
| 1427605278 | Liana Zucco | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Centre, Dept Anesthesia, 330 Brookline Ave, Ya-02q02, Boston, MA 02215 | 2019-08-26 |
| 1831759430 | Brian William Hayes | Radiology | 330 Brookline Avenue, Beth Israel Deaconess Medical Cen, Boston, MA 02215 | 2019-06-17 |
| 1396304358 | Elizabeth Hai Yen Du | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Center, Department of Rad, 330 Brookline Avenue, Boston, MA 02215 | 2019-06-12 |
| 1922665439 | Corey Shaphard Miller | Student in an Organized Health Care Education/Training Program | 300 Brookline Avenue, Bidmc, Dana 501, Boston, MA 02215 | 2019-05-21 |
| Find all providers in zip 02215 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083168256 | Shreyans Shah | Psychiatry & Neurology | 330 Brookline Ave, Shapiro 8 Tcc, Boston, MA 02215-5400 | 2016-08-05 |
| 1649227356 | Kaarkuzhali Babu Krishnamurthy | Psychiatry & Neurology | 736 Cambridge St, Boston, MA 02135-2907 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255642286 | Gina Deck | Psychiatry & Neurology | Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805 | 2010-06-24 |
| 1164743092 | Neurology of Central Massachusetts, PC | Psychiatry & Neurology | 50 Memorial Dr, Suite 211, Leominster, MA 01453-2238 | 2010-06-15 |
| 1932339025 | Swapna Lakshmi Putta | Psychiatry & Neurology | 55 Fogg Road, Bwh Department of Neurology, Emerson 150, South Weumouth, MA 02190 | 2009-07-23 |
| 1275723413 | George A. Gonzalez, M.d., P.C. | Psychiatry & Neurology | 131 Old Road To 9 Acre Cor, Suite 660, Concord, MA 01742-4181 | 2007-07-25 |
| 1427255538 | Green Mountain Neurology, Inc | Psychiatry & Neurology | 777 North St, Suite 205, Pittsfield, MA 01201-4147 | 2007-07-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.