MEDICARE: DR. JAY I STARR 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	207Q00000X	Family Medicine Physician	NY134036	NM

General Provider Information

NPI Number	:	1487670105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY I STARR MD

Provider Business Mailing Address
First Line	:	1755 DEER PARK AVE
Second Line	:
City	:	DEER PARK
State	:	NY
Zip	:	11729-5207
Country	:	US
Telephone Number	:	631-667-0388
Fax Number	:	631-254-3028

Provider Business Practice Location Address
First Line	:	1755 DEER PARK AVE
Second Line	:
City	:	DEER PARK
State	:	NY
Zip	:	11729-5207
Country	:	US
Telephone Number	:	631-667-0388
Fax Number	:	631-254-3028

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/08/2007

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