Individual
JONATHAN B TICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
660 BROADWAY, MASSAPEQUA, NY 11758-2312
(516) 798-0111
(516) 798-0152
Mailing address
660 BROADWAY, MASSAPEQUA, NY 11758-2312
(516) 798-0111
(516) 798-0152
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
180039
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010180039NY
ANTHEM
NY
01
—
1044724
FIRST HEALTH
NY
01
—
1309558
CIGNA
NY
01
—
1445199
UNITED
NY
05
—
1570938
—
NY
01
—
180039S
HEALTHCARE PARTNERS
NY
01
—
1C0831
HEALTHNET
NY
01
—
2000021570
RR MEDICARE
NY
01
—
30293P
HIP
NY
01
—
35497526
MULTIPLAN
NY
01
—
501030
GHI CBP
NY
01
—
5103229
AETNA PPO
NY
01
—
531270
AETNA US HEALTHCARE
NY
01
—
60G781
BLUE CROSS BLUE SHIELD
NY
01
—
68711
GHI HMO
NY
01
—
AA47457
MDNY
NY
01
—
AS1634
OXFORD
NY
01
—
GHI PPO
0501005
NY
Enumeration date
06/30/2006
Last updated
11/09/2009
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