Provider Demographics
NPI:1003943275
Name:RASHBAUM, JAY M (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:M
Last Name:RASHBAUM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1410 BROADWAY
Mailing Address - Street 2:SUITE 3004
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-5007
Mailing Address - Country:US
Mailing Address - Phone:212-391-1385
Mailing Address - Fax:212-391-8540
Practice Address - Street 1:1410 BROADWAY
Practice Address - Street 2:SUITE 3004
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-5007
Practice Address - Country:US
Practice Address - Phone:212-391-1385
Practice Address - Fax:212-391-8540
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0298471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice