Organization
JEROME L. SHUPACK, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME LEONARD SHUPACK MD (PRESIDENT)
(212) 263-7344
Entity
Organization
Contact information
Practice address
530 1ST AVE # 7F, NEW YORK, NY 10016-6402
(212) 263-7344
(212) 263-5991
Mailing address
530 1ST AVE # 7F, NEW YORK, NY 10016-6402
(212) 263-7344
(212) 263-5991
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
092742
NY
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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