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General NPI Number Information
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NPI Number | 1003823576
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Entity Type | Individual
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Provider Name | JEFFREY W MILSOM M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 1315 YORK AVE 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10021-5304
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Country | US
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Telephone | 212-746-6030
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Fax |
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Provider Business Mailing Address
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Address Line | 525 E 68TH ST SUITE PAYSON 717, MAILBOX 172
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City | NEW YORK
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State | NY
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Zip | 10021-4870
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Country | US
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Telephone | 212-746-6030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 145242
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 145242
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License Number State | NY
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