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General NPI Number Information
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NPI Number | 1053483164
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Entity Type | Organization
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Legal Business Name | JAY M PURVIN, DPM
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 02/15/2011
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Provider Practice Location Address
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Address Line | 336 CEDAR LN
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City | EAST MEADOW
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State | NY
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Zip | 11554-2714
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Country | US
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Telephone | 516-489-1950
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Fax | 516-489-6861
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Provider Business Mailing Address
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Address Line | 336 CEDAR LN
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City | EAST MEADOW
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State | NY
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Zip | 11554-2714
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Country | US
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Telephone | 516-489-1950
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Fax | 516-489-6861
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Authorized Official
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Title or Position | DPM
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Name | JAY M PURVIN
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Credential | DPM
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Telephone | 516-489-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | NO029711
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License Number State | NY
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