Provider Demographics
NPI:1881632487
Name:ARNETT, JAN MUNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:MUNEY
Last Name:ARNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2910
Mailing Address - Country:US
Mailing Address - Phone:718-204-6667
Mailing Address - Fax:718-956-8514
Practice Address - Street 1:4207 30TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2910
Practice Address - Country:US
Practice Address - Phone:718-204-6667
Practice Address - Fax:718-956-8514
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136859207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00593137Medicaid
NY46A561Medicare ID - Type Unspecified
NY00593137Medicaid
NY52396GMedicare ID - Type UnspecifiedMEDICARE GHI IN QUEENS