Individual
DR. TODD R JORGENSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 MAIN ST, QUEENSBURY, NY 12804-4007
(518) 798-0767
(518) 798-0815
Mailing address
17 MAIN ST, QUEENSBURY, NY 12804-4007
(518) 798-0767
(518) 798-0815
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2084721
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01894462
—
NY
Enumeration date
02/22/2006
Last updated
07/08/2007
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