MEDICARE: RYAN JUNEAU CNIM

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	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1861362550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN JUNEAU CNIM

Provider Business Mailing Address
First Line	:	50 ROSE PL
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-5311
Country	:	US
Telephone Number	:	888-279-6336
Fax Number	:

Provider Business Practice Location Address
First Line	:	7350 JEFFERSON HWY STE 485-105
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-8269
Country	:	US
Telephone Number	:	888-279-6336
Fax Number	:

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

Provider Enumeration Date	:	11/07/2025
Last Update Date	:	02/05/2026

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Directions to “ RYAN JUNEAU CNIM” Practice Location

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