Healthcare Provider Details

I. General information

NPI: 1104271717
Provider Name (Legal Business Name): JGE CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 05/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 MIDDLE COUNTRY RD
SELDEN NY
11784-2550
US

IV. Provider business mailing address

761 MIDDLE COUNTRY RD
SELDEN NY
11784-2550
US

V. Phone/Fax

Practice location:
  • Phone: 631-736-4064
  • Fax: 631-736-1332
Mailing address:
  • Phone: 631-736-4064
  • Fax: 631-736-1332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY EVAN GROPPER
Title or Position: OWNER
Credential: D.O.
Phone: 631-716-6000