MEDICARE: LOUIS D. JABLIN DPM

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1386826204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUIS D. JABLIN DPM

Provider Business Mailing Address
First Line	:	6105 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4609
Country	:	US
Telephone Number	:	718-439-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	6105 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4609
Country	:	US
Telephone Number	:	718-439-8888
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LOUIS D JABLIN
Credential	:	DPM
Telephone Number	:	718-439-8888

Provider Enumeration Date	:	12/03/2007
Last Update Date	:	12/03/2007

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