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General NPI Number Information
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NPI Number | 1649073651
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Entity Type | Individual
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Provider Name | JOHANE JEAN
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Gender | Female
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 680 E MAIN ST
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City | STAMFORD
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State | CT
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Zip | 06901-2113
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Country | US
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Telephone | 929-417-6053
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Fax |
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Provider Business Mailing Address
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Address Line | 2408 CLARENDON RD APT 4C
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City | BROOKLYN
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State | NY
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Zip | 11226-6295
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Country | US
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Telephone | 929-417-6053
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Fax |
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number | HCA.0002609
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License Number State | CT
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