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General NPI Number Information
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NPI Number | 1235303124
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Entity Type | Individual
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Provider Name | JONATHAN HOUSE MD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1050 5TH AVE OFFICE #4
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City | NEW YORK
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State | NY
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Zip | 10028-0110
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Country | US
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Telephone | 212-722-5345
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Fax | 646-672-0741
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Provider Business Mailing Address
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Address Line | 1050 5TH AVE OFFICE #4
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City | NEW YORK
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State | NY
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Zip | 10028-0110
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Country | US
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Telephone | 212-722-5345
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Fax | 646-672-0741
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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 | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number | 138275
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 138275
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License Number State | NY
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