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General NPI Number Information
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NPI Number | 1124162714
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Entity Type | Organization
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Legal Business Name | JAY C COWAN MD LLC
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 470 MALCOLM X BLVD SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10037-3003
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Country | US
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Telephone | 212-281-5252
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Fax | 212-690-3662
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Provider Business Mailing Address
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Address Line | 470 MALCOLM X BLVD SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10037-3003
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Country | US
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Telephone | 212-281-5252
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Fax | 212-690-3662
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Authorized Official
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Title or Position | MD
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Name | DR. JAY C COWAN
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Credential | MD
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Telephone | 212-281-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 201885
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License Number State | NY
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