Provider Demographics
NPI:1598780272
Name:PENTECOSTES, JILL U (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:U
Last Name:PENTECOSTES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:186 JORALEMON ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4326
Mailing Address - Country:US
Mailing Address - Phone:718-858-1233
Mailing Address - Fax:718-858-5095
Practice Address - Street 1:186 JORALEMON ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4326
Practice Address - Country:US
Practice Address - Phone:718-858-1233
Practice Address - Fax:718-858-5095
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY208295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH21890Medicare UPIN