MEDICARE: JAY BEN ADLERSBERG 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	207RR0500X	Rheumatology Physician	113920	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	319481	OTHER	NY	BCBS
2	NS2357	OTHER	NY	OXF

General Provider Information

NPI Number	:	1629140033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY BEN ADLERSBERG MD

Provider Business Mailing Address
First Line	:	1 RESEARCH RD
Second Line	:
City	:	RIDGE
State	:	NY
Zip	:	11961-2701
Country	:	US
Telephone Number	:	631-751-3000
Fax Number	:	631-751-0506

Provider Business Practice Location Address
First Line	:	12 E 86TH ST OFC 3
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-0517
Country	:	US
Telephone Number	:	212-517-9555
Fax Number	:

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/02/2025

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