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Organization

JUNO MEDICAL PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANTE HINSON MD (OWNER)
(609) 320-7998
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
01/31/2020
Last updated
03/01/2023
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