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General NPI Number Information
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NPI Number | 1780827022
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Entity Type | Individual
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Provider Name | JORDAN T. KERKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 651 OLD COUNTRY RD
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City | PLAINVIEW
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State | NY
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Zip | 11803-4938
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Country | US
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Telephone | 516-681-8822
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Fax | 516-681-3332
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Provider Business Mailing Address
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Address Line | 651 OLD COUNTRY RD
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City | PLAINVIEW
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State | NY
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Zip | 11803-4938
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Country | US
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Telephone | 516-681-8822
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Fax | 516-681-3332
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME148197
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 246675
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 246675
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License Number State | NY
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