Provider Demographics
NPI:1275509820
Name:JENKINS, ARTHUR L III (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:L
Last Name:JENKINS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 GUSTAVE L LEVY PLACE
Mailing Address - Street 2:BOX 1136B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-0002
Mailing Address - Fax:212-831-3250
Practice Address - Street 1:65 EAST 96TH STREET
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6574
Practice Address - Country:US
Practice Address - Phone:646-499-0488
Practice Address - Fax:646-810-6486
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2020-02-06
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Provider Licenses
StateLicense IDTaxonomies
NY196344207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02168578Medicaid
NY4R3462Medicare ID - Type UnspecifiedEMPIRE MEDICARE
NY02168578Medicaid