MEDICARE: JMRN CONSULTANT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1083467419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JMRN CONSULTANT LLC

Provider Business Mailing Address
First Line	:	5450 NETHERLAND AVE APT E21
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-2431
Country	:	US
Telephone Number	:	917-589-7149
Fax Number	:	914-219-0955

Provider Business Practice Location Address
First Line	:	3533 RIVERDALE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1829
Country	:	US
Telephone Number	:	917-589-7149
Fax Number	:	914-219-0955

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSHUA BERNSTEIN
Credential	:
Telephone Number	:	917-589-7149

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	04/08/2024

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