MEDICARE: JEFTER CYRIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1144802356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFTER CYRIN

Provider Business Mailing Address
First Line	:	1 WATERMILL RD
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-6528
Country	:	US
Telephone Number	:	845-642-7918
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 WATERMILL RD
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-6528
Country	:	US
Telephone Number	:	845-642-7918
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2021
Last Update Date	:	04/27/2021

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Directions to “ JEFTER CYRIN ” Practice Location

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