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General NPI Number Information
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NPI Number | 1295968972
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Entity Type | Individual
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Provider Name | JANET S. RANDALL M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2009
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 16 MIDDLE NECK RD STE 262
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City | GREAT NECK
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State | NY
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Zip | 11021-2357
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Country | US
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Telephone | 800-477-8092
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Fax | 561-526-2524
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Provider Business Mailing Address
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Address Line | 6052 VIA VENETIA N
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6403
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Country | US
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Telephone | 800-477-8092
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Fax | 561-526-2524
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 60-117129
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License Number State | NY
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