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NPI Code Detail

MEDICARE: JOHN DUJMOVIC APRN

MEDICARE: JOHN DUJMOVIC APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner350583NY
2363LF0000XFamily Nurse Practitioner1069798TX
3363L00000XNurse PractitionerARNP11024290FL

General Provider Information

NPI Number : 1013626365
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN DUJMOVIC APRN
Provider Business Mailing Address
First Line : 489 5TH AVE FL 3
Second Line :
City : NEW YORK
State : NY
Zip : 10017-6145
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 489 5TH AVE FL 3
Second Line :
City : NEW YORK
State : NY
Zip : 10017-6145
Country : US
Telephone Number : 415-651-6791
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2022
Last Update Date : 03/23/2026

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