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General NPI Number Information
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NPI Number | 1922691526
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Entity Type | Organization
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Legal Business Name | JD & IY CORP
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Dates
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Enumeration Date | 02/15/2021
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 201 HIGHLAWN AVE
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City | BROOKLYN
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State | NY
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Zip | 11223-2647
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Country | US
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Telephone | 718-872-6607
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Fax | 718-872-6608
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Provider Business Mailing Address
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Address Line | 3033 BRIGHTON 13TH ST APT A8
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City | BROOKLYN
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State | NY
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Zip | 11235-5623
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Country | US
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Telephone | 718-872-6607
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Fax | 718-872-6608
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Authorized Official
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Title or Position | DIRECTOR
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Name | INESSA STOGNIY
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Credential |
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Telephone | 718-872-6607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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