Healthcare Provider Details

I. General information

NPI: 1821908740
Provider Name (Legal Business Name): JASON ARJUNE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 PLAINS RD
BALLSTON SPA NY
12020-4520
US

IV. Provider business mailing address

291 PLAINS RD
BALLSTON SPA NY
12020-4520
US

V. Phone/Fax

Practice location:
  • Phone: 518-965-3673
  • Fax:
Mailing address:
  • Phone: 518-965-3673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number847439-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: