Individual
JORDAN ROSS WALDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
121 DEKALB AVE, BROOKLYN, NY 11201-5493
(718) 250-8000
Mailing address
3100 DENTON DR, MERRICK, NY 11566-5115
(516) 244-5824
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
696827-01
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
696827
NY
Other
Enumeration date
07/29/2020
Last updated
11/03/2023
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