Provider Demographics
NPI:1073580031
Name:EPSTEIN, JEFFREY M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 JOHN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2928
Mailing Address - Country:US
Mailing Address - Phone:631-669-0500
Mailing Address - Fax:631-661-0463
Practice Address - Street 1:51 JOHN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2928
Practice Address - Country:US
Practice Address - Phone:631-669-0500
Practice Address - Fax:631-661-0463
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNS143892174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY82D521Medicare ID - Type Unspecified
NYA64422Medicare UPIN