=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568544955
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHARLES I. JAROWSKI, M.D.,PC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2006
-----------------------------------------------------
Last Update Date | 04/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 E 77TH ST STE 1A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10075-2366
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-794-9500
-----------------------------------------------------
Fax | 212-734-8350
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 E 77TH ST STE 1A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10075-2366
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-794-9500
-----------------------------------------------------
Fax | 212-734-8350
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. JOAN JAROWSKI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 212-794-9500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 116780
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------