Individual
SURESH P JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13420 JAMAICA AVE, 1ST FL, JAMAICA, NY 11418
(718) 206-6742
(718) 206-8818
Mailing address
49 HAMILTON DR, ROSLYN, NY 11576-3128
(516) 640-5669
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
240921
NY
207RI0011X
Interventional Cardiology Physician
Primary
240921
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1496871
—
LA
Enumeration date
07/25/2006
Last updated
06/15/2018
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