Healthcare Provider Details

I. General information

NPI: 1467367466
Provider Name (Legal Business Name): JUN JIANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13620 MAPLE AVE # C705
FLUSHING NY
11355-5166
US

IV. Provider business mailing address

13620 MAPLE AVE # C705
FLUSHING NY
11355-5166
US

V. Phone/Fax

Practice location:
  • Phone: 718-888-0316
  • Fax:
Mailing address:
  • Phone: 718-888-0316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number433699
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: