MEDICARE: DR. JAMES CURTIS MCINTOSH JR. MD

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	2084P0800X	Psychiatry Physician	157558	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	157558	OTHER	NY	LICENCE NUMBER

General Provider Information

NPI Number	:	1275663106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES CURTIS MCINTOSH JR. MD

Provider Business Mailing Address
First Line	:	666 LINDEN BLVD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-3213
Country	:	US
Telephone Number	:	718-693-3513
Fax Number	:

Provider Business Practice Location Address
First Line	:	666 LINDEN BLVD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-3213
Country	:	US
Telephone Number	:	718-693-3513
Fax Number	:

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/08/2007

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