=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972303006
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JVSHEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2025
-----------------------------------------------------
Last Update Date | 04/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5925 ALTON ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80238-3995
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-606-4960
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 ROMANA DR
-----------------------------------------------------
City | HAMPTON BAYS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11946-3718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-606-4960
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SETH RICHARD HYMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 917-796-5994
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------