Individual
MR. JUSTIN JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
560 W 168TH ST, NEW YORK, NY 10032-3917
(212) 305-4318
Mailing address
127 NORMAN DR, EAST MEADOW, NY 11554-1639
(516) 303-6814
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
747312
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
154923
NY
Other
Enumeration date
06/13/2022
Last updated
08/18/2025
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