JUNO MEDICAL PRACTICE, PLLC (NPI# 1558992206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558992206 |
| Entity Type | Organization |
| Organization Name | JUNO MEDICAL PRACTICE, PLLC |
| Practice Address |
2119 Frederick Douglass Blvd New York NY 10026-2392 |
| Mailing Address |
1485 5th Ave Apt 18c New York NY 10035-2778 |
| Practice Telephone | 2123002836 |
| Mailing Telephone | 2123002836 |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-05-12 |
| Authorized Official Name | SHANTE HINSON (OWNER) |
| Authorized Official Telephone | 6093207998 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 207 W 115th St, New York, NY 100262965 | 6093207998 |
| Street Address |
2119 FREDERICK DOUGLASS BLVD |
| City | NEW YORK |
| State | NY |
| Zip Code | 10026-2392 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538704663 | Glenda Murdaugh | Social Worker | 130 Lenox Avenue, Apt. 613, New York, NY 10026 | 2019-11-13 |
| 1043702574 | Gwendolyn Miller | Counselor | Create Inc, 73-75 Lenox Ave, New York, NY 10026 | 2018-05-31 |
| 1013423391 | Herman L Jackson | Physical Therapy Assistant | Physical Therapy of Harlem 1400 5th Ave, New York City, NY 10026 | 2017-12-21 |
| 1497264915 | Yudith O. Mahon | Registered Nurse | 110 West 114th Street Apt. 1b, New York, NY 10026 | 2017-09-27 |
| 1124546254 | Carmen Raina Abagail Lalonde | Psychologist | 155 West 72nd Street, Suite 505, Manhattan, NY 10026 | 2017-09-09 |
| 1972053387 | Crate | Community/Behavioral Health | 73 Lenox Avenue, New York, NY 10026 | 2016-10-10 |
| 1770931875 | Wendy P Nick | Speech-Language Pathologist | 240 W 113th St, New York, NY 10026 | 2016-05-30 |
| 1720464209 | Barbara D. Leese | Social Worker | 305 W 118th St, New York, NY 10026 | 2015-08-06 |
| 1982091880 | Philip Miller I | Counselor | 121 West 111th Street, New York, NY 10026 | 2015-04-20 |
| 1154711612 | Create, Inc. | Substance Abuse Rehabilitation Facility | 121-123 West 111th Street, New York, NY 10026 | 2015-02-04 |
| Find all providers in zip 10026 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1336799295 | Wellness Medical Services of Manhattan PC | Clinic/Center | 51 E 25th St Ste 499, New York, NY 10010-2945 | 2019-09-12 |
| 1174089056 | City Medical of Upper East Side, Pllc | Clinic/Center | 216 E 14th St Ste B, New York, NY 10003-4105 | 2019-02-15 |
| 1093282329 | The Medical Offices of Occupational Health Resources P C | Clinic/Center | 500 W 33rd St, New York, NY 10001-1301 | 2018-10-24 |
| 1134615016 | City Integrative Medicine PC | Clinic/Center | 56 W 45th St Fl 8, New York, NY 10036-4215 | 2018-07-03 |
| 1659878312 | Medical Offices of Occupational Health Resources P C | Clinic/Center | 175 Greenwich St, 3 World Trade Center, New York, NY 10007-9998 | 2018-04-10 |
| 1609375344 | Iheart Health and Wellness | Clinic/Center | 131 W 33rd St Fl 14, New York, NY 10001-2938 | 2018-02-08 |
| 1447758610 | Medical Offices of Occupational Health Resources P C | Clinic/Center | 55 E 52nd St, New York, NY 10055-0002 | 2018-01-23 |
| 1952834343 | Sheltering Arms Children and Family Services, Inc. | Clinic/Center | 305 7th Ave Fl 4, New York, NY 10001-6280 | 2017-04-04 |
| 1184164113 | Medical Offices of Occupational Health Resources P C | Clinic/Center | 230 Park Ave S, New York, NY 10003-1528 | 2017-02-23 |
| Find all providers in NEW YORK | ||||
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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.