Healthcare Provider Details

I. General information

NPI: 1720577489
Provider Name (Legal Business Name): JANET MARVA BOWEN RN/BSN/MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 SCHENECTADY AVE
BROOKLYN NY
11203-1822
US

IV. Provider business mailing address

1561EAST 94TH STREET
BROOKLYN NY
11236
US

V. Phone/Fax

Practice location:
  • Phone: 347-462-2547
  • Fax:
Mailing address:
  • Phone: 973-412-6336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number5278731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: