Provider Demographics
NPI:1992117238
Name:ST. JUSTE, JENDAYI
Entity type:Individual
Prefix:
First Name:JENDAYI
Middle Name:
Last Name:ST. JUSTE
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 1:220 W 148TH ST APT 3M
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3169
Mailing Address - Country:US
Mailing Address - Phone:212-748-9722
Mailing Address - Fax:
Practice Address - Street 1:220 W 148TH ST APT 3M
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-3169
Practice Address - Country:US
Practice Address - Phone:212-748-9722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst