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General NPI Number Information
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NPI Number | 1598079956
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Entity Type | Individual
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Provider Name | TODD M JARRELL MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 64 BLEECKER ST # 151
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City | NEW YORK
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State | NY
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Zip | 10012-2410
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Country | US
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Telephone | 302-313-1584
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Fax |
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Provider Business Mailing Address
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Address Line | 64 BLEECKER ST # 151
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City | NEW YORK
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State | NY
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Zip | 10012-2410
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Country | US
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Telephone | 302-313-1584
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ML60165757
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License Number State | WA
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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 | P3735
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License Number State | TX
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