Healthcare Provider Details

I. General information

NPI: 1649562414
Provider Name (Legal Business Name): MICHAEL DAVID JUREWICZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 CENTRAL AVE
FAR ROCKAWAY NY
11691-4002
US

IV. Provider business mailing address

1612 CENTRAL AVE
FAR ROCKAWAY NY
11691-4002
US

V. Phone/Fax

Practice location:
  • Phone: 718-970-8700
  • Fax:
Mailing address:
  • Phone: 248-860-0211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number282765
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: