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General NPI Number Information
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NPI Number | 1235406596
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Entity Type | Organization
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Legal Business Name | JACOB HEYMAN,M,D., P.C.
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 109 E 38TH ST GROUND FL
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City | NEW YORK
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State | NY
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Zip | 10016-2684
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Country | US
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Telephone | 212-684-4900
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Fax | 212-684-3515
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Provider Business Mailing Address
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Address Line | 109 E 38TH ST GROUND FL
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City | NEW YORK
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State | NY
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Zip | 10016-2684
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Country | US
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Telephone | 212-684-4900
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Fax | 212-684-3515
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACOB H HEYMAN
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Credential | M.D.
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Telephone | 212-684-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 140674
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License Number State | NY
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