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General NPI Number Information
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NPI Number | 1033914874
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Entity Type | Organization
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Legal Business Name | CDJR CONSULTING LLC
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 360 NEW DORP LN
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3035
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Country | US
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Telephone | 718-814-7797
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Fax |
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Provider Business Mailing Address
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Address Line | 360 NEW DORP LN
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3035
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Country | US
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Telephone | 718-814-7797
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CHRISTIAN DEFOURNOY JR.
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Credential | NP
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Telephone | 929-312-1468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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