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NPI Code Detail

MEDICARE: DR. JASBIR GREWAL M.D.

MEDICARE: DR. JASBIR GREWAL M.D.
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
12085R0202XDiagnostic Radiology PhysicianC1-002511DE
22085R0202XDiagnostic Radiology Physician036.176281IL
32085R0202XDiagnostic Radiology Physician154278NY
42085R0202XDiagnostic Radiology PhysicianW0413TX

Other Identifiers

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

General Provider Information

NPI Number : 1881731560
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASBIR GREWAL M.D.
Provider Business Mailing Address
First Line : 158 W 27TH ST
Second Line : 11TH FL. SOUTH
City : NEW YORK
State : NY
Zip : 10001-6216
Country : US
Telephone Number : 212-563-2497
Fax Number : 212-563-0605
Provider Business Practice Location Address
First Line : 8201 E RIVERSIDE BLVD
Second Line :
City : ROCKFORD
State : IL
Zip : 61114-2300
Country : US
Telephone Number : 815-971-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 01/21/2026

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