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NPI Code Detail

MEDICARE: DR. MICHAEL ROBERT JURKOWICH M.D.

MEDICARE: DR. MICHAEL ROBERT JURKOWICH M.D.
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
1208VP0014XInterventional Pain Medicine Physician270951NY
2208100000XPhysical Medicine & Rehabilitation Physician270951NY
32081S0010XSports Medicine (Physical Medicine & Rehabilitation) Physician270951NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184868531
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL ROBERT JURKOWICH M.D.
Provider Business Mailing Address
First Line : PO BOX 22239
Second Line :
City : NEW YORK
State : NY
Zip : 10087-0001
Country : US
Telephone Number : 702-899-0595
Fax Number : 702-977-1496
Provider Business Practice Location Address
First Line : 1440 PORT WASHINGTON BLVD
Second Line :
City : PORT WASHINGTON
State : NY
Zip : 11050-2412
Country : US
Telephone Number : 702-899-0595
Fax Number : 702-977-1496
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2009
Last Update Date : 12/04/2025

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