Individual
JORDAN S ORANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 W 168TH ST # ST1, NEW YORK, NY 10032-3725
(212) 305-2934
Mailing address
630 W 168TH ST # ST1, NEW YORK, NY 10032-3725
(212) 305-2934
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
294122
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015806
—
NJ
05
—
100820449
—
PA
Enumeration date
07/28/2006
Last updated
02/10/2023
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