Provider Demographics
NPI:1316701261
Name:JULIANA KANJI PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:JULIANA KANJI PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-427-1100
Mailing Address - Street 1:775 PARK AVE SUITE 154
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-427-1100
Mailing Address - Fax:631-784-7748
Practice Address - Street 1:775 PARK AVE SUITE 154
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-427-1100
Practice Address - Fax:631-784-7748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty