Provider Demographics
NPI:1154790988
Name:VASSELL-MUIR, JOAN ANN
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:ANN
Last Name:VASSELL-MUIR
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 1:1234 E 84TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4912
Mailing Address - Country:US
Mailing Address - Phone:347-204-8212
Mailing Address - Fax:
Practice Address - Street 1:1234 E 84TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4912
Practice Address - Country:US
Practice Address - Phone:347-204-8212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323267251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health