Provider Demographics
NPI:1073580387
Name:PAUL, JANEEN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JANEEN
Middle Name:H
Last Name:PAUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W 27TH ST STE 5S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6208
Mailing Address - Country:US
Mailing Address - Phone:917-634-5311
Mailing Address - Fax:888-815-3583
Practice Address - Street 1:1301 RIVERPLACE BLVD STE 800
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-9032
Practice Address - Country:US
Practice Address - Phone:833-351-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1031002084P0800X
NY3198162084P0800X
FLME1636782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633221OtherBCBS PROVIDER NUMBER
IL01633221OtherBCBS PROVIDER NUMBER
ILK02825Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER