Provider Demographics
NPI:1063455202
Name:CAPOOR, JAISHREE (MD)
Entity Type:Individual
Prefix:
First Name:JAISHREE
Middle Name:
Last Name:CAPOOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:404 EAST 66TH STREET
Mailing Address - Street 2:APT 12G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:917-558-3593
Mailing Address - Fax:646-390-3217
Practice Address - Street 1:94-25 59TH AVENUE
Practice Address - Street 2:UNIT F7
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-760-1600
Practice Address - Fax:718-760-1634
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-08-12
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Provider Licenses
StateLicense IDTaxonomies
NY2156932081P0004X, 2081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02230188Medicaid
NY02230188Medicaid
NY33T128Medicare ID - Type Unspecified