Provider Demographics
NPI:1134136484
Name:OPPENHEIM, JEFFREY S (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:OPPENHEIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 CROSFIELD AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2233
Mailing Address - Country:US
Mailing Address - Phone:845-368-0286
Mailing Address - Fax:845-368-1653
Practice Address - Street 1:2 CROSFIELD AVE STE 102
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2233
Practice Address - Country:US
Practice Address - Phone:845-368-0286
Practice Address - Fax:845-368-1653
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178719207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF75819Medicare UPIN