Provider Demographics
NPI:1467601294
Name:JUSINO, EVA JANNETTE
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:JANNETTE
Last Name:JUSINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FF-11 CALLE 37
Mailing Address - Street 2:URB JARDINES DE CAPARRA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-0000
Mailing Address - Country:US
Mailing Address - Phone:787-565-6869
Mailing Address - Fax:
Practice Address - Street 1:FF-11 CALLE 37
Practice Address - Street 2:URB JARDINES DE CAPARRA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-565-6869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor