# MICHAEL R JURKOWICH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558017038
- **Authorized official:** DEBRA L SCOTT (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (407) 797-5958

## Contact information

- **Practice address:** 783 POST RD \# 785, SCARSDALE, NY 10583-5010
- **Practice address phone:** (718) 554-1171
- **Mailing address:** 7 FAIRVIEW AVE, PORT WASHINGTON, NY 11050-4013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 02/23/2022
- **Last updated:** 02/23/2022