Provider Demographics
NPI:1750321626
Name:MAYER, JEFFREY R (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:R
Last Name:MAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 EAST MAIN STREET
Mailing Address - Street 2:NORTHERN WESTCHESTER HOSPITAL ATTN: MEDICAL AFFAIRS OFF
Mailing Address - City:MT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-666-1254
Mailing Address - Fax:914-666-1965
Practice Address - Street 1:400 EAST MAIN STREET
Practice Address - Street 2:NORTHERN WESTCHESTER HOSPITAL EMERGENCY ROOM
Practice Address - City:MT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-666-1254
Practice Address - Fax:914-666-1931
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY217698207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000106123OtherGHI HMO PIN#
NY060707000001OtherFIDELIS CARE OF NY PIN #
1082049OtherAETNA HMO
2288Q1OtherBCBS
2154190OtherUNITED HEALTHCARE PIN #
4147739OtherMVP
P3650590OtherOXFORD HEALTH PLAN PIN #
10087294OtherCDPHP PIN#
1082049OtherAETNA HMO PIN #
7033196OtherAETNA PPO
NY0112699OtherGHI PPO
5C4627OtherHEALTHNET PIN #
P3650590OtherOXFORD HEALTH PLAN PIN #
NY678V773781Medicare PIN
1082049OtherAETNA HMO