Provider Demographics
NPI:1326358631
Name:ST JOY, JEAN A
Entity Type:Individual
Prefix:MR
First Name:JEAN
Middle Name:A
Last Name:ST JOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 LEFFERT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225
Mailing Address - Country:US
Mailing Address - Phone:718-922-2092
Mailing Address - Fax:
Practice Address - Street 1:532 LEFFERT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225
Practice Address - Country:US
Practice Address - Phone:718-922-2092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299282164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse