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NPI Code Detail

MEDICARE: JAGGER CORABI MD

MEDICARE: JAGGER CORABI 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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1902748973
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAGGER CORABI MD
Provider Business Mailing Address
First Line : 1213 WALNUT ST APT 1701
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-4959
Country : US
Telephone Number : 631-697-1766
Fax Number :
Provider Business Practice Location Address
First Line : 630 W 168TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3725
Country : US
Telephone Number : 877-426-5637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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