Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | F350384-1 | NY |
NPI | 1033583661 |
---|---|
Provider Name | Jinto John |
First Address | Flushing, NY 11355-5045 |
Second Address | Flushing, NY 11355-5045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2015 |
Last Update Date | 19/11/2015 |