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General NPI Number Information
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NPI Number | 1538805957
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Entity Type | Organization
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Legal Business Name | BIJUVENATION
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 188 POST AVE UNIT A
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City | WESTBURY
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State | NY
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Zip | 11590-3060
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Country | US
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Telephone | 516-477-9935
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Fax |
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Provider Business Mailing Address
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Address Line | 188 POST AVE UNIT A
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City | WESTBURY
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State | NY
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Zip | 11590-3060
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Country | US
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Telephone | 516-477-9935
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BIJU K JOSE
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Credential |
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Telephone | 516-477-9935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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