MEDICARE: JAY ARTHUR KERNER

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	305S00000X	Point of Service

General Provider Information

NPI Number	:	1932816147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAY ARTHUR KERNER

Provider Business Mailing Address
First Line	:	314 DEMOTT AVE
Second Line	:
City	:	ROCKVILLE CENTRE
State	:	NY
Zip	:	11570-1854
Country	:	US
Telephone Number	:	516-223-4026
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 DEMOTT AVE
Second Line	:
City	:	ROCKVILLE CENTRE
State	:	NY
Zip	:	11570-1854
Country	:	US
Telephone Number	:	516-223-4026
Fax Number	:	516-330-7917

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAY A KERNER
Credential	:
Telephone Number	:	516-223-4026

Provider Enumeration Date	:	10/28/2022
Last Update Date	:	10/28/2022

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Directions to “JAY ARTHUR KERNER ” Practice Location

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