Provider Demographics
NPI:1376165613
Name:JEANNE B DAMIAN MD PC
Entity Type:Organization
Organization Name:JEANNE B DAMIAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-269-6303
Mailing Address - Street 1:18 W 48TH ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1800
Mailing Address - Country:US
Mailing Address - Phone:646-269-6303
Mailing Address - Fax:417-313-0858
Practice Address - Street 1:2091 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2549
Practice Address - Country:US
Practice Address - Phone:718-434-1876
Practice Address - Fax:718-690-7100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-09
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty