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General NPI Number Information
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NPI Number | 1205017142
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Entity Type | Individual
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Provider Name | JAYNE ELIZABETH JORDAN RPAC
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Gender | Female
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 80 5TH AVE FL 3
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City | NEW YORK
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State | NY
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Zip | 10011-8002
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Country | US
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Telephone | 212-229-1671
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Fax | 212-598-0059
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Provider Business Mailing Address
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Address Line | 80 5TH AVE FL 3
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City | NEW YORK
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State | NY
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Zip | 10011-8002
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Country | US
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Telephone | 212-229-1671
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Fax | 212-598-0059
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 004921
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License Number State | NY
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