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NPI Code Detail

MEDICARE: DR. BASEL JAZBEH M.D.

MEDICARE: DR. BASEL JAZBEH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianME140203FL
2207L00000XAnesthesiology Physician70513CT
3207L00000XAnesthesiology Physician295491NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073958963
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BASEL JAZBEH M.D.
Provider Business Mailing Address
First Line : 575 LEXINGTON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10022-6102
Country : US
Telephone Number : 917-861-1483
Fax Number :
Provider Business Practice Location Address
First Line : 5645 MAIN ST
Second Line :
City : FLUSHING
State : NY
Zip : 11355-5045
Country : US
Telephone Number : 718-670-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2013
Last Update Date : 04/24/2026

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