| Juspen Enterprises Incorportated | |
|
4400 Stamp Rd Suite 314 Temple Hills MD 20748-6716 | |
| (301) 702-0047 | |
| (301) 702-0841 |
| Full Name | Juspen Enterprises Incorportated |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4400 Stamp Rd, Temple Hills, Maryland |
| Authorized Official Name and Position | Spencer F Johnson (CEO) |
| Authorized Official Contact | 3017065358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Juspen Enterprises Incorportated 11703 Amer Ct Fort Washington MD 20744-5953 Ph: (301) 292-8751 | Juspen Enterprises Incorportated 4400 Stamp Rd Suite 314 Temple Hills MD 20748-6716 Ph: (301) 702-0047 |
| NPI Number | 1154488013 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 05/14/2008 |
| Medicare PECOS PAC ID | 1052378304 |
|---|---|
| Medicare Enrollment ID | O20041217000624 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154488013 | NPI | - | NPPES |
| 025905700 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Spencer F Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063579779 PECOS PAC ID: 8123059946 Enrollment ID: I20080924000112 |
| Provider Name | Raymond A Ofe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003168964 PECOS PAC ID: 6204149693 Enrollment ID: I20150714001538 |
| Provider Name | Nji J Fru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275893794 PECOS PAC ID: 8224374319 Enrollment ID: I20190610000895 |
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