=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588031488
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JONATHAN KIRSCH ARAD MDPC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2015
-----------------------------------------------------
Last Update Date | 08/26/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 967 N BROADWAY
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10701-1301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-693-0055
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 967 N BROADWAY
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10701-1301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-693-0055
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SURGEON
-----------------------------------------------------
Name | JONATHAN ARAD
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 914-693-0055
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 268725
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------