Provider Demographics
NPI:1649596727
Name:WASHINGTON, JEFFREY (RDMS,RDCS)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:RDMS,RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PLAINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1263
Mailing Address - Country:US
Mailing Address - Phone:516-984-5834
Mailing Address - Fax:516-326-2749
Practice Address - Street 1:1 PLAINFIELD AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1263
Practice Address - Country:US
Practice Address - Phone:516-326-7772
Practice Address - Fax:516-326-2749
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY38369246XC2903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist