Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 173256 | NY |
NPI | 1154385920 |
---|---|
Provider Name | Dr. Jordan G Pritzker |
First Address | Great Neck, NY 11021-5502 |
Second Address | Manhasset, NY 11030-3006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01585015 | (05) | NY |
E62765 | (02) |