Healthcare Provider Details

I. General information

NPI: 1831727494
Provider Name (Legal Business Name): MRS. BEATRICE OLUYEMISI OWOEYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JAMAICA MEDICAL CENTER 8900 VAN WYCK EXPRESS
JAMAICA NY
11418
US

IV. Provider business mailing address

11219 168TH ST
JAMAICA NY
11433-3917
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-7208
  • Fax: 718-206-7230
Mailing address:
  • Phone: 917-841-1483
  • Fax: 718-206-7230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: