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General NPI Number Information
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NPI Number | 1891345666
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Entity Type | Organization
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Legal Business Name | JRR MEDICAL PC
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 2569 OCEAN AVE STE 3
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City | BROOKLYN
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State | NY
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Zip | 11229-4576
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Country | US
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Telephone | 718-210-2960
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Fax | 718-744-9374
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Provider Business Mailing Address
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Address Line | 139 N 3RD ST
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City | BROOKLYN
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State | NY
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Zip | 11249-3933
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Country | US
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Telephone | 718-210-2960
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Fax | 718-744-9374
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Authorized Official
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Title or Position | OWNER
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Name | JASON RUBINOV
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Credential | MD
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Telephone | 718-210-2960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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