Provider Demographics
NPI:1497973226
Name:TOWNSEND, JAMES EDWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 S JERSEY AVE
Mailing Address - Street 2:UNIT #1
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2034
Mailing Address - Country:US
Mailing Address - Phone:631-343-3140
Mailing Address - Fax:631-343-3124
Practice Address - Street 1:100 S JERSEY AVE
Practice Address - Street 2:UNIT #1
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2034
Practice Address - Country:US
Practice Address - Phone:631-343-3140
Practice Address - Fax:631-343-3124
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB078072002084P0800X
NY2485882084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03028324Medicaid
NYA400002999Medicare PIN