Provider Demographics
NPI:1023340791
Name:JUNOR, MIRIAM STEPHANIE (CDE)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:STEPHANIE
Last Name:JUNOR
Suffix:
Gender:F
Credentials:CDE
Other - Prefix:MRS
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:JUNOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDE
Mailing Address - Street 1:3424 KOSSUTH AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2410
Mailing Address - Country:US
Mailing Address - Phone:718-515-1434
Mailing Address - Fax:718-515-1496
Practice Address - Street 1:3424 KOSSUTH AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2410
Practice Address - Country:US
Practice Address - Phone:718-515-1434
Practice Address - Fax:718-515-1496
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY467489-1163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator