Individual
DR. JONATHAN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 GUSTAVE L LEVY PL DEPT OF, NEW YORK, NY 10029
(860) 214-4650
Mailing address
1 GUSTAVE L LEVY PL DEPT OF, NEW YORK, NY 10029-6504
(860) 214-4650
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
295418-1
NY
Other
Enumeration date
05/31/2013
Last updated
04/25/2019
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