Provider Demographics
NPI:1578541207
Name:AINSPAN, JEFFREY LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LOUIS
Last Name:AINSPAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:72 EILEEN DR
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-2806
Mailing Address - Country:US
Mailing Address - Phone:201-327-8704
Mailing Address - Fax:212-505-2565
Practice Address - Street 1:308A E 15TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-505-5790
Practice Address - Fax:212-505-2565
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155051207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07A0102OtherABC HEALTHPLAN
NY1000003251OtherAFFINITY
NYAINSJ064OtherGREAT WEST ONE HEALTHPLAN
NY11112286OtherMULTIPLAN
NY2340394OtherAETNA HMO
NY5317347OtherAETNA PPO
NY70D571OtherEMPIRE BCBS
NY000000092884OtherGHI HMO
NY155051OtherHIP
NY155051-H20OtherHEALTH FIRST
NY31496OtherHIP CMO
NY4C5623OtherHEALTH NET
NY0014933OtherGHI PPO
NY990121OtherCIGNA
NYP852474OtherOXFORD
NY31496OtherHIP CMO
NY0014933OtherGHI PPO