Individual
DR. DANY YOUSSEF JABBOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
91 MONTGOMERY ST, RHINEBECK, NY 12572-1146
(845) 876-8637
(845) 876-0218
Mailing address
91 MONTGOMERY ST, RHINEBECK, NY 12572-1146
(845) 876-8637
(845) 876-0218
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
006140
NY
213EP1101X
Primary Podiatric Medicine Podiatrist
006140
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N006140-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000932161004
BS NORTHEASTERN NY PIN/IDENTIFIER
—
05
—
02911622
—
NY
01
—
30061
TAX ID LAST 5 DIGITS
—
01
—
93-2014012
TAX ID
NY
01
—
CJ2100
RAILROAD MEDICARE GROUP PIN/IDENTIFIER
—
01
—
GRP408871001
BLUE SHIELD NORTHEASTERN NY GROUP PIN/IDENTIFIER
—
01
—
PM4111
BLUE CROSS PRUE SHIELD PIN/IDENTIFIER
—
Enumeration date
07/29/2006
Last updated
09/09/2024
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