Healthcare Provider Details

I. General information

NPI: 1427866698
Provider Name (Legal Business Name): J3 HEALTHCARE MANAGEMENT AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 01/11/2025
Certification Date: 01/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 OVINGTON AVE STE 203
BROOKLYN NY
11209-1458
US

IV. Provider business mailing address

474 OVINGTON AVE APT 1D
BROOKLYN NY
11209-1555
US

V. Phone/Fax

Practice location:
  • Phone: 347-298-4100
  • Fax: 347-227-1368
Mailing address:
  • Phone: 347-298-4100
  • Fax: 347-227-1368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. JONA J TAJONERA
Title or Position: MANAGER
Credential:
Phone: 347-298-4100