Healthcare Provider Details

I. General information

NPI: 1912226473
Provider Name (Legal Business Name): CARLINE JEUNES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 COCHRAN PL
VALLEY STREAM NY
11581-1847
US

IV. Provider business mailing address

6424 18TH AVE
BROOKLYN NY
11204-3729
US

V. Phone/Fax

Practice location:
  • Phone: 516-295-1219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number639770
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number296909
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: