MEDICARE: JOY EVOH

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
1	163WI0500X	Infusion Therapy Registered Nurse	599209	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F405671-01	NY

General Provider Information

NPI Number	:	1518135813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY EVOH

Provider Business Mailing Address
First Line	:	65 EDGEWOOD AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10704-2438
Country	:	US
Telephone Number	:	917-657-2878
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PELHAM PKWY S BLDG 16
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1119
Country	:	US
Telephone Number	:	718-918-4243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	05/20/2024

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Directions to “ JOY EVOH ” Practice Location

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