Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 177258 | NY |
NPI | 1235104324 |
---|---|
Provider Name | Dr. Jeffrey M. Birnbaum |
First Address | Brooklyn, NY 11231-2730 |
Second Address | Brooklyn, NY 11203-2098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 13/06/2008 |