Gaetan, Juan

Gaetan, Juan is an individual health care provider with primary practice located at 82-68 164Th St. Department Of Emergency Medicine, Jamaica NY 11432-1121. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is his primary health care specialty. Gaetan, Juan can be contacted via phone (718) 883-3075.

Contact Information

Primary practice address
82-68 164Th St. Department Of Emergency Medicine Jamaica NY 11432-1121
Phone: (718) 883-3075
Fax: (718) 883-6115
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 466314 New York
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X F381315 New York

Profile Details

NPI number 1730165192
LBN Legal business name Gaetan, Juan
Credentials CPNP-PC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated May 30th, 2024 - about 6 months 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 1730165192 NPPES
New York MEDICAID 02267756

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