Organization
JSM WELLNESS NP IN ACUTE CARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JI SOO MOON DNP (PRESIDENT)
(917) 945-2497
Entity
Organization
Contact information
Practice address
215 HALLOCK RD STE 6A, STONY BROOK, NY 11790-3077
(917) 563-1824
Mailing address
215 HALLOCK RD STE 6A, STONY BROOK, NY 11790-3077
(917) 563-1824
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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