Individual
DR. JAY IYPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 ROUTE 112, SUITE #11, MEDFORD, NY 11763
(631) 732-5222
(631) 732-6222
Mailing address
2799 ROUTE 112, SUITE #11, MEDFORD, NY 11763
(631) 732-5222
(631) 732-6222
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
231749
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02559680
—
NY
01
—
6B6671
EMPIRE BC.BS
NY
01
—
7662603
AETNA
NY
Enumeration date
06/04/2006
Last updated
05/16/2016
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