Provider Demographics
NPI:1902527526
Name:JAMIL, MAYSUN S
Entity type:Individual
Prefix:
First Name:MAYSUN S
Middle Name:
Last Name:JAMIL
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 1:1433 GLOVER ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4919
Mailing Address - Country:US
Mailing Address - Phone:347-774-6670
Mailing Address - Fax:
Practice Address - Street 1:1433 GLOVER ST FL 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4919
Practice Address - Country:US
Practice Address - Phone:347-774-6670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator