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Individual

DR. BEVERLY JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD, FAAP

Contact information

Practice address
760 BROADWAY, WOODHULL HOSPITAL DEPARTMENT OF PEDIATRICS, BROOKLYN, NY 11206-5317
(718) 963-7956
(718) 963-7957
Mailing address
760 BROADWAY, WOODHULL HOSPITAL DEPARTMENT OF PEDIATRICS, BROOKLYN, NY 11206-5317
(718) 963-7956
(718) 963-7957

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
054577
GA
208000000X
Pediatrics Physician
Primary
281964
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
301530833
NY
Enumeration date
04/18/2006
Last updated
10/21/2015
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