Brathwaite, Jillene Myrnelle

Brathwaite, Jillene Myrnelle is an individual health care provider with primary practice located at 40 Arch St , Johnson City NY 13790-2102. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is her primary health care specialty. Brathwaite, Jillene Myrnelle can be contacted via phone (607) 763-6092.

Contact Information

Primary practice address
40 Arch St Johnson City NY 13790-2102
Phone: (607) 763-6092
Fax: (607) 763-6677
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 254046 New York
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 254046 New York
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 254046 New York

Profile Details

NPI number 1174753743
LBN Legal business name Brathwaite, Jillene Myrnelle
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2009
Last updated Jul 5th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174753743 NPPES
New York MEDICAID 03128012

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