Provider Demographics
NPI:1669673836
Name:MOSSOP, JUNE ANDREA (MD)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:ANDREA
Last Name:MOSSOP
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:MC CA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:228 LINDA AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2050
Practice Address - Country:US
Practice Address - Phone:914-773-7449
Practice Address - Fax:914-747-5647
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2023022084P0804X
PAMD4689782084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY202302OtherLICENSE #