Provider Demographics
NPI:1225002314
Name:NEW ROCHELLE MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:NEW ROCHELLE MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JESMAJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-365-3160
Mailing Address - Street 1:16 GUION PL
Mailing Address - Street 2:ISELIN HALL, ROOM 107
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5502
Mailing Address - Country:US
Mailing Address - Phone:914-365-3353
Mailing Address - Fax:914-365-5150
Practice Address - Street 1:16 GUION PL
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5503
Practice Address - Country:US
Practice Address - Phone:914-365-3160
Practice Address - Fax:914-365-5150
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUND SHORE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-15
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01480560Medicaid
NYW24991Medicare PIN