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Individual

DR. JONATHAN MATTHEW BARASCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-1592
Mailing address
630 W 168TH ST # 4, VC 12TH FLOOR, SUITE 208, NEW YORK, NY 10032-3725

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
181132
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01243732
NY
Enumeration date
01/04/2007
Last updated
07/08/2007
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