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General NPI Number Information
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NPI Number | 1477637312
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Entity Type | Individual
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Provider Name | JESSE ANDREW STOFF MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 70 GLEN ST SUITE 300
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City | GLEN COVE
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State | NY
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Zip | 11542-2855
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Country | US
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Telephone | 516-759-4200
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Fax | 516-759-7600
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Provider Business Mailing Address
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Address Line | PO BOX 640247
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-0247
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Country | US
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Telephone | 520-241-1944
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Fax |
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 150159
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 150519
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License Number State | NY
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