Healthcare Provider Details

I. General information

NPI: 1992041669
Provider Name (Legal Business Name): JUNE JOSEPH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2012
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BROADWAY
NEW YORK NY
10032-1559
US

IV. Provider business mailing address

15 SAINT ANDREWS PL APT. 2C
YONKERS NY
10705-3154
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-8600
  • Fax:
Mailing address:
  • Phone: 347-866-2194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number350342
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: