Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 255396 | NY |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 255396 | NY |
NPI | 1023144771 |
---|---|
Provider Name | Seth Allen Jerabek |
First Address | New York, NY 10087-9234 |
Second Address | New York, NY 10021-4823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 01/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03478159 | (05) | NY |