Provider Demographics
NPI:1285630368
Name:DUBOWSKY, JAY J (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:J
Last Name:DUBOWSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3040
Mailing Address - Country:US
Mailing Address - Phone:516-407-4000
Mailing Address - Fax:516-627-4208
Practice Address - Street 1:1155 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3040
Practice Address - Country:US
Practice Address - Phone:516-407-4000
Practice Address - Fax:516-627-4208
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199241207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH04365Medicare UPIN
NY55B841Medicare ID - Type Unspecified