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Individual

JACK RANDY POPE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3251 THIRD AVE, BRONX, NY 10456-6832
(347) 236-9938
(347) 281-9138
Mailing address
45 FAIRVIEW AVE APT 1E, NEW YORK, NY 10040-2752
(646) 852-8651

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
12/01/2023
Last updated
12/01/2023
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