Individual
MR. JOSE RAFAEL JEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3959 BROADWAY, COLUMBIA UNIVERSITY DEPARTMENT PEDIATRICS, NEW YORK, NY 10032-1559
(212) 304-7250
(212) 544-1974
Mailing address
143 SCHOR AVE, LEONIA, NJ 07605-2237
(201) 461-0626
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
159415
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00844899
—
NY
Enumeration date
03/20/2006
Last updated
01/03/2013
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