Individual
JASON CHARLES LE VERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
214 W HOUSTON ST, NEW YORK, NY 10014-4846
(212) 337-9400
Mailing address
8635 QUEENS BLVD APT 3S, ELMHURST, NY 11373-4438
(831) 207-6154
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
012184-01
NY
Other
Enumeration date
11/01/2019
Last updated
11/01/2019
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