Healthcare Provider Details

I. General information

NPI: 1174450837
Provider Name (Legal Business Name): JUVENISE JEAN BAPTISTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WILLOW AVE
HEMPSTEAD NY
11550-7034
US

IV. Provider business mailing address

125 WILLOW AVE
HEMPSTEAD NY
11550-7034
US

V. Phone/Fax

Practice location:
  • Phone: 407-244-6981
  • Fax: 407-244-6981
Mailing address:
  • Phone: 407-244-6981
  • Fax: 407-244-6981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN33162
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: