Provider Demographics
NPI:1003812173
Name:CASE, JEAN BROOKHART (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:BROOKHART
Last Name:CASE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:635 MADISON AVE
Mailing Address - Street 2:FL 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1009
Mailing Address - Country:US
Mailing Address - Phone:212-857-4661
Mailing Address - Fax:212-752-2454
Practice Address - Street 1:635 MADISON AVE
Practice Address - Street 2:FL 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1009
Practice Address - Country:US
Practice Address - Phone:212-857-4661
Practice Address - Fax:212-752-2454
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY112043207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH45739Medicare UPIN
NYJC0010AT10Medicare ID - Type Unspecified