MEDICARE: JAY WINZELBERG P.A.

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	363A00000X	Physician Assistant	009315	NY

General Provider Information

NPI Number	:	1831344456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY WINZELBERG P.A.

Provider Business Mailing Address
First Line	:	6010 BAY PKWY
Second Line	:	STE 901
City	:	BROOKLYN
State	:	NY
Zip	:	11204-6081
Country	:	US
Telephone Number	:	718-238-2100
Fax Number	:	718-475-1821

Provider Business Practice Location Address
First Line	:	7734 113TH ST
Second Line	:	APT. B
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7133
Country	:	US
Telephone Number	:	718-544-6650
Fax Number	:

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

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	09/22/2016

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