Provider Demographics
NPI:1578538732
Name:LIGH, JONATHAN KENNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:KENNARD
Last Name:LIGH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:345 E 37TH ST
Mailing Address - Street 2:SUITE 315
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3256
Mailing Address - Country:US
Mailing Address - Phone:212-983-4510
Mailing Address - Fax:212-983-6520
Practice Address - Street 1:345 E 37TH ST
Practice Address - Street 2:SUITE 315
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3256
Practice Address - Country:US
Practice Address - Phone:212-983-4510
Practice Address - Fax:212-983-6520
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2008-08-12
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Provider Licenses
StateLicense IDTaxonomies
NY139298207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO6542Medicare UPIN
NY19D391Medicare ID - Type UnspecifiedEMPIRE BS/BC