Provider Demographics
NPI:1669451886
Name:NIGHTINGALE, JEFFREY DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DAVID
Last Name:NIGHTINGALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:211 CENTRAL PARK W
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6020
Mailing Address - Country:US
Mailing Address - Phone:212-877-7188
Mailing Address - Fax:212-877-3912
Practice Address - Street 1:211 CENTRAL PARK W
Practice Address - Street 2:SUITE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6020
Practice Address - Country:US
Practice Address - Phone:212-877-7188
Practice Address - Fax:212-877-3912
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY118287207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00200728Medicaid
NYA62047Medicare UPIN
NY303521Medicare ID - Type Unspecified