MEDICARE: DR. JILL ROBIN BARON 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
1	207Q00000X	Family Medicine Physician	171742-1	NY

General Provider Information

NPI Number	:	1235272097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL ROBIN BARON M.D.

Provider Business Mailing Address
First Line	:	1036 PARK AVE STE 1B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-0971
Country	:	US
Telephone Number	:	646-472-5043
Fax Number	:	646-224-6946

Provider Business Practice Location Address
First Line	:	1036 PARK AVE STE 1B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-0971
Country	:	US
Telephone Number	:	646-472-5043
Fax Number	:	646-224-6946

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	04/20/2022

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