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General NPI Number Information
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NPI Number | 1184868531
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Entity Type | Individual
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Provider Name | MICHAEL ROBERT JURKOWICH M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1440 PORT WASHINGTON BLVD
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-2412
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Country | US
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Telephone | 702-899-0595
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Fax | 702-977-1496
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Provider Business Mailing Address
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Address Line | PO BOX 22239
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City | NEW YORK
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State | NY
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Zip | 10087-0001
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Country | US
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Telephone | 702-899-0595
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Fax | 702-977-1496
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 270951
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 270951
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 270951
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License Number State | NY
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