Provider Demographics
NPI:1275018921
Name:MJN MEDICAL PLLC
Entity Type:Organization
Organization Name:MJN MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:914-374-4057
Mailing Address - Street 1:39 W 29TH ST FL 11
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4249
Mailing Address - Country:US
Mailing Address - Phone:212-920-7833
Mailing Address - Fax:
Practice Address - Street 1:39 W 29TH ST
Practice Address - Street 2:FL 11
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-920-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty