Individual
JEREMY JEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(347) 798-9213
Mailing address
41 ERNST AVE, BLOOMFIELD, NJ 07003-4508
(973) 619-8331
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
329988-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
MT217733
PA
Other
Enumeration date
05/21/2019
Last updated
06/19/2024
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