Healthcare Provider Details

I. General information

NPI: 1013839174
Provider Name (Legal Business Name): 2 5TH AVENUE MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 5TH AVE STE 9
NEW YORK NY
10011-8855
US

IV. Provider business mailing address

2 5TH AVE STE 9
NEW YORK NY
10011-8855
US

V. Phone/Fax

Practice location:
  • Phone: 646-580-3538
  • Fax: 844-841-8382
Mailing address:
  • Phone: 646-580-3538
  • Fax: 844-841-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON SIEFFERMAN
Title or Position: PARTBER
Credential: MD
Phone: 646-580-3538