Provider Demographics
NPI:1659558740
Name:ROSS, JEFFREY ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ADAM
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 PARK AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1601
Mailing Address - Country:US
Mailing Address - Phone:212-457-0331
Mailing Address - Fax:860-262-7455
Practice Address - Street 1:99 PARK AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1601
Practice Address - Country:US
Practice Address - Phone:212-457-0331
Practice Address - Fax:860-262-7455
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-051488207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine