Healthcare Provider Details

I. General information

NPI: 1407796535
Provider Name (Legal Business Name): SHAWN BRADLEY JEUNE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 DUCK POND RD
CASTLETON ON HUDSON NY
12033-9656
US

IV. Provider business mailing address

1515 DUCK POND RD
CASTLETON ON HUDSON NY
12033-9656
US

V. Phone/Fax

Practice location:
  • Phone: 518-542-9782
  • Fax:
Mailing address:
  • Phone: 518-542-9782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number508436
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: