Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 279686 | NY |
N | 111NI0900X | Internist | 279686 | NY |
Y | 207RH0002X | Hospice and Palliative Medicine | 279686 | NY |
NPI | 1326335217 |
---|---|
Provider Name | Dr. Jason Potts Meadows |
First Address | New York, NY 10065-6007 |
Second Address | New York, NY 10065-6007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 02/09/2015 |