Provider Demographics
NPI:1164922936
Name:JORDAN MEYERS MD PC
Entity Type:Organization
Organization Name:JORDAN MEYERS MD PC
Other - Org Name:MILLENNIUM PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-241-1488
Mailing Address - Street 1:5322 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3910
Mailing Address - Country:US
Mailing Address - Phone:718-241-1488
Mailing Address - Fax:
Practice Address - Street 1:5322 AVENUE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3910
Practice Address - Country:US
Practice Address - Phone:718-241-1488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-17
Last Update Date:2018-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty