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NPI Code Detail

MEDICARE: JYOTSNA MARY GEORGE MD

MEDICARE: JYOTSNA MARY GEORGE 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1376248781
Entity Type Code : Individual
Provider Name (Legal Business Name) : JYOTSNA MARY GEORGE MD
Provider Business Mailing Address
First Line : 3495 BAILEY AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14215-1129
Country : US
Telephone Number : 716-862-8567
Fax Number : 716-862-7812
Provider Business Practice Location Address
First Line : 3495 BAILEY AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14215-1129
Country : US
Telephone Number : 716-862-8567
Fax Number : 716-862-7812
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2023
Last Update Date : 05/18/2026

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