JACK JEDWAB MD PC NPI 1194096404

NPI Information

NPI: 1194096404
Provider Name: JACK JEDWAB MD PC
Classification: Urology - 208800000X
Entity Type: Organization
Address:
2270 KIMBALL ST
BROOKLYN, NY
ZIP 11234
Phone: (718) 377-7575
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JACK JEDWAB MD PC is an urology in Brooklyn, NY. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. JACK JEDWAB MD PC NPI is 1194096404. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2270 KIMBALL ST
BROOKLYN, NY
ZIP 11234-139
Phone: (718) 377-7575

The provider's authorized official is Jack Jedwab .
The authorized official title is President and has the following contact phone number (718) 377-7575.

The enumeration date for this NPI number is 1/18/2012 and was last updated on 1/18/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208800000X	Urology		139976	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	27A801	MEDICARE PIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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