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General NPI Number Information
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NPI Number | 1740433697
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Entity Type | Organization
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Legal Business Name | JP MEDICAL OF NY PC
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Dates
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Enumeration Date | 10/23/2008
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 1829 E 13TH ST UNIT 1A
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City | BROOKLYN
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State | NY
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Zip | 11229-2886
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Country | US
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Telephone | 551-486-0281
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Fax | 201-567-3208
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Provider Business Mailing Address
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Address Line | 1829 E 13TH ST UNIT 1A
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City | BROOKLYN
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State | NY
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Zip | 11229-2886
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Country | US
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Telephone | 551-486-0281
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Fax | 201-567-3208
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Authorized Official
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Title or Position | MANAGER
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Name | LINDA PISKUN
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Credential |
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Telephone | 551-486-0281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 2157451
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License Number State | NY
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