Healthcare Provider Details

I. General information

NPI: 1639255615
Provider Name (Legal Business Name): JULIANNE KIMBERLY JOY SUOJANEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 01/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 GRASSLANDS ROAD NYMC BEHAVIORAL HEALTH CENTER ROOM N326
VALHALLA NY
10595
US

IV. Provider business mailing address

95 GRASSLANDS ROAD NYMC BEHAVIORAL HEALTH CENTER ROOM N326
VALHALLA NY
10595
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7124
  • Fax: 914-493-1015
Mailing address:
  • Phone: 914-493-7124
  • Fax: 914-493-1015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number235303
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: