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NPI Code Detail

MEDICARE: STANLEY JEAN

MEDICARE: STANLEY JEAN
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
1227900000XRegistered Respiratory Therapist0066711NY

General Provider Information

NPI Number : 1588106645
Entity Type Code : Individual
Provider Name (Legal Business Name) : STANLEY JEAN
Provider Business Mailing Address
First Line : 7 SHERWOOD AVE APT 11
Second Line :
City : OSSINING
State : NY
Zip : 10562-3549
Country : US
Telephone Number : 917-288-7007
Fax Number :
Provider Business Practice Location Address
First Line : 3304 WATERBURY AVE
Second Line :
City : BRONX
State : NY
Zip : 10465-1554
Country : US
Telephone Number : 718-931-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2016
Last Update Date : 11/07/2016

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Directions to “ STANLEY JEAN ” Practice Location

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