# JUNO MEDICAL PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558992206
- **Authorized official:** SHANTE HINSON MD (OWNER)
- **Authorized official phone:** (609) 320-7998

## Contact information

- **Practice address:** 2119 FREDERICK DOUGLASS BLVD, NEW YORK, NY 10026-2392
- **Practice address phone:** (212) 300-2836
- **Mailing address:** 1485 5TH AVE APT 18C, NEW YORK, NY 10035-2778
- **Mailing address phone:** (212) 300-2836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RR0500X | Rheumatology Physician | — | NULL | — |
| 207RR0500X | Rheumatology Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/31/2020
- **Last updated:** 03/01/2023