Provider Demographics
NPI:1770510471
Name:JAEGER, JEAN ANN (MD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:ANN
Last Name:JAEGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:2400 ROUTE 9
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-4725
Practice Address - Country:US
Practice Address - Phone:845-231-5600
Practice Address - Fax:845-537-5977
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01417138Medicaid
NYF69768Medicare UPIN
NYA400024267Medicare PIN
NYA400116399Medicare PIN