Healthcare Provider Details

I. General information

NPI: 1669461851
Provider Name (Legal Business Name): JANICE KRYSTAL ASCENCIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13303 JAMAICA AVE # 6A
RICHMOND HILL NY
11418-2618
US

IV. Provider business mailing address

8906 135TH ST APT 6A
RICHMOND HILL NY
11418-2823
US

V. Phone/Fax

Practice location:
  • Phone: 718-291-3276
  • Fax: 718-526-5456
Mailing address:
  • Phone: 718-206-6808
  • Fax: 718-206-6829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number225860
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: