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General NPI Number Information
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NPI Number | 1831809854
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Entity Type | Organization
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Legal Business Name | JUNO MEDICAL PRACTICE
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 777 MEMORIAL DR SE UNIT A200
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City | ATLANTA
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State | GA
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Zip | 30316-1582
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Country | US
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Telephone | 212-300-2836
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Fax |
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Provider Business Mailing Address
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Address Line | 228 PARK AVE S # 34199
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City | NEW YORK
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State | NY
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Zip | 10003-1502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AARTI AGARWAL
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Credential | MD
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Telephone | 617-304-6260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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