Individual
MR. JONATHAN TAD FOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1470 METROPOLITAN AVE, BRONX, NY 10462-7446
(718) 571-9270
(716) 859-7388
Mailing address
1345 RXR PLZ FL 13, UNIONDALE, NY 11556-1301
(516) 453-0435
(646) 846-3283
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
248396
NY
2085R0204X
Vascular & Interventional Radiology Physician
248396
NY
Other
Enumeration date
07/14/2005
Last updated
10/23/2018
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