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General NPI Number Information
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NPI Number | 1588674329
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Entity Type | Individual
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Provider Name | MICHAEL G JAEGER MD
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 125 HARRY HOWARD AVE FIREMENS NURSING HOME
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City | HUDSON
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State | NY
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Zip | 12534-1601
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Country | US
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Telephone | 518-828-7695
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Fax | 518-828-0561
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Provider Business Mailing Address
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Address Line | 24 LEGRAND AVE
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City | TIVOLI
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State | NY
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Zip | 12583-5023
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Country | US
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Telephone | 518-537-5873
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Fax | 518-537-5873
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 188311
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License Number State | NY
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