Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N005380 | NY |
NPI | 1164481222 |
---|---|
Provider Name | Dr. John Alexander Jarbath |
First Address | Hempstead, NY 11550-3521 |
Second Address | Hempstead, NY 11550-3521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2006 |
Last Update Date | 25/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01808786 | (05) | NY |
U62597 | (02) | NY |