Provider Demographics
NPI:1669461851
Name:ASCENCIO, JANICE KRYSTAL (MD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:KRYSTAL
Last Name:ASCENCIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8906 135TH ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2823
Mailing Address - Country:US
Mailing Address - Phone:718-206-6808
Mailing Address - Fax:718-206-6829
Practice Address - Street 1:13303 JAMAICA AVE # 6A
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2618
Practice Address - Country:US
Practice Address - Phone:718-291-3276
Practice Address - Fax:718-526-5456
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225860207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02610520Medicaid
NYA400108870Medicare PIN
NYH95203Medicare UPIN