Provider Demographics
NPI:1083722896
Name:TAYLOR, JAMES ROY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROY
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 NICOLLS RD
Mailing Address - Street 2:HSC L19-080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8191
Mailing Address - Country:US
Mailing Address - Phone:631-444-1820
Mailing Address - Fax:631-444-8963
Practice Address - Street 1:100 NICOLLS RD
Practice Address - Street 2:HSC L19-080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8191
Practice Address - Country:US
Practice Address - Phone:631-444-1820
Practice Address - Fax:631-444-8963
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-10-12
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Provider Licenses
StateLicense IDTaxonomies
NY165177208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01248948Medicaid
NYE17704Medicare UPIN
NY01248948Medicaid