Healthcare Provider Details

I. General information

NPI: 1518135813
Provider Name (Legal Business Name): JOY EVOH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S BLDG 16
BRONX NY
10461-1119
US

IV. Provider business mailing address

65 EDGEWOOD AVE
YONKERS NY
10704-2438
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-4243
  • Fax:
Mailing address:
  • Phone: 917-657-2878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number599209
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF405671-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: