Provider Demographics
NPI:1497926075
Name:TOSK, JARRETT N (MD)
Entity Type:Individual
Prefix:DR
First Name:JARRETT
Middle Name:N
Last Name:TOSK
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 1:75 VANDERBILT AVE
Mailing Address - Street 2:DEPT. OF PSYCHIATRY
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2604
Mailing Address - Country:US
Mailing Address - Phone:718-818-6300
Mailing Address - Fax:
Practice Address - Street 1:75 VANDERBILT AVE
Practice Address - Street 2:DEPT. OF PSYCHIATRY
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2604
Practice Address - Country:US
Practice Address - Phone:718-818-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2635392084P0800X
NJ25MA092127002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03461754Medicaid