Individual provider Active NPI

Justine Wend-Yam Boena

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1124947528
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
862187 Issued in NY
Practice address
222 E 204TH St
Bronx, NY 10458-1316
Phone
(347) 479-0378
NPI assigned
Jul 11, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 862187 NY Primary

Addresses

Primary practice location

222 E 204TH St
Bronx, NY 10458-1316

Mailing address

222 E 204TH St Apt 6G
Bronx, NY 10458-1327
Phone (347) 479-0378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1783728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1124947528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E 204TH ST APT 6G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581327",
            "telephone_number": "347-479-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E 204TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581316",
            "telephone_number": "347-479-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENA",
        "first_name": "JUSTINE",
        "middle_name": "WEND-YAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-11",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "862187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.