MEDICARE: JPC MEDICAL 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	261Q00000X	Clinic/Center	157407-1	NY

General Provider Information

NPI Number	:	1619412988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JPC MEDICAL PC

Provider Business Mailing Address
First Line	:	1612 KINGS HWY
Second Line	:	SUITE 143
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1210
Country	:	US
Telephone Number	:	718-629-2030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1552 RALPH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3129
Country	:	US
Telephone Number	:	718-629-2030
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. JEAN P PERNIER
Credential	:	MD
Telephone Number	:	718-629-2030

Provider Enumeration Date	:	12/22/2016
Last Update Date	:	12/22/2016

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Directions to “JPC MEDICAL PC ” Practice Location

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