Provider Demographics
NPI:1306829429
Name:VORSANGER, JEFFREY ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:VORSANGER
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 1:241 BEACH 136TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1323
Mailing Address - Country:US
Mailing Address - Phone:718-634-1228
Mailing Address - Fax:
Practice Address - Street 1:2560 OCEAN AVE
Practice Address - Street 2:SUITE 3B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4507
Practice Address - Country:US
Practice Address - Phone:718-646-7878
Practice Address - Fax:718-646-4259
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141179207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY141179OtherNYS LICENSE
NYB20267Medicare UPIN
94A771Medicare ID - Type Unspecified