MEDICARE: JAY W ENEMAN MD, PC

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	2251X0800X	Orthopedic Physical Therapist	132580	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1295859841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAY W ENEMAN MD, PC

Provider Business Mailing Address
First Line	:	PO BOX 330
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-0330
Country	:	US
Telephone Number	:	516-897-9000
Fax Number	:	516-897-9827

Provider Business Practice Location Address
First Line	:	780 LONG BEACH BLVD
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-2238
Country	:	US
Telephone Number	:	516-897-9000
Fax Number	:	516-897-9827

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAY W ENEMAN
Credential	:	M.D.
Telephone Number	:	516-897-9000

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	02/28/2008

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