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General NPI Number Information
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NPI Number | 1295859841
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Entity Type | Organization
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Legal Business Name | JAY W ENEMAN MD, PC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 780 LONG BEACH BLVD
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City | LONG BEACH
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State | NY
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Zip | 11561-2238
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Country | US
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Telephone | 516-897-9000
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Fax | 516-897-9827
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Provider Business Mailing Address
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Address Line | PO BOX 330
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City | WOODMERE
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State | NY
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Zip | 11598-0330
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Country | US
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Telephone | 516-897-9000
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Fax | 516-897-9827
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAY W ENEMAN
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Credential | M.D.
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Telephone | 516-897-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 132580
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License Number State | NY
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