MEDICARE: DR. JAMES ROBERT MUSSMAN 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	207R00000X	Internal Medicine Physician	228971	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	:	1346219615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ROBERT MUSSMAN MD

Provider Business Mailing Address
First Line	:	150 LOCKWOOD AVE
Second Line	:	SUITE 32
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-4912
Country	:	US
Telephone Number	:	914-632-1235
Fax Number	:	914-632-2553

Provider Business Practice Location Address
First Line	:	150 LOCKWOOD AVE
Second Line	:	SUITE 32
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-4912
Country	:	US
Telephone Number	:	914-632-1235
Fax Number	:	914-632-2553

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	02/16/2024

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