Provider Demographics
NPI:1437664380
Name:JESSICA AU MD PLLC
Entity Type:Organization
Organization Name:JESSICA AU MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-886-5267
Mailing Address - Street 1:39 WEST 29TH STREET
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:646-770-0916
Mailing Address - Fax:646-797-4628
Practice Address - Street 1:39 WEST 29TH STREET
Practice Address - Street 2:11TH FLOOR
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:646-770-0916
Practice Address - Fax:646-797-4628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty