Provider Demographics
NPI:1952937443
Name:SINCLAIR, JULENE JUNE
Entity type:Individual
Prefix:
First Name:JULENE
Middle Name:JUNE
Last Name:SINCLAIR
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 1:1371 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7403
Mailing Address - Country:US
Mailing Address - Phone:917-767-0779
Mailing Address - Fax:
Practice Address - Street 1:1371 METROPOLITAN AVE APT 3013
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7403
Practice Address - Country:US
Practice Address - Phone:718-597-7690
Practice Address - Fax:718-597-7696
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0654470183500000X
NY06544701835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support