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NPI Code Detail

MEDICARE: JOAN JASIEN M.D.

MEDICARE: JOAN JASIEN M.D.
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
12084P0005XNeurodevelopmental Disabilities Physician2014-02407NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1390200000XOTHERCTCONNETICUT

General Provider Information

NPI Number : 1881865566
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN JASIEN M.D.
Provider Business Mailing Address
First Line : 3000 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4504
Country : US
Telephone Number : 919-668-4468
Fax Number :
Provider Business Practice Location Address
First Line : 3000 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4504
Country : US
Telephone Number : 919-668-4468
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2008
Last Update Date : 10/27/2025

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