MEDICARE: JOHN EDWARD BOWEN JR. MD

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	207P00000X	Emergency Medicine Physician	ME136152	FL
2	146L00000X	Paramedic
3	390200000X	Student in an Organized Health Care Education/Training Program
4	207P00000X	Emergency Medicine Physician	51294	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1215322144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN EDWARD BOWEN JR. MD

Provider Business Mailing Address
First Line	:	4802 10TH AVE
Second Line	:	MAIMONIDES MEDICAL CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2916
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4802 10TH AVE
Second Line	:	MAIMONIDES MEDICAL CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11219
Country	:	US
Telephone Number	:	718-283-8000
Fax Number	:

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

Provider Enumeration Date	:	03/30/2015
Last Update Date	:	04/27/2026

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