Provider Demographics
NPI:1841093572
Name:BOUSLEIMAN, JAMIE JOE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:JOE
Last Name:BOUSLEIMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W 54TH ST APT 26P
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5996
Mailing Address - Country:US
Mailing Address - Phone:201-694-1281
Mailing Address - Fax:
Practice Address - Street 1:550 W 54TH ST APT 26P
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5996
Practice Address - Country:US
Practice Address - Phone:201-694-1281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program