Provider Demographics
NPI:1770630907
Name:ORR, JONATHAN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:THOMAS
Last Name:ORR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:17 OHEHYAHTAH PL
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7668
Mailing Address - Country:US
Mailing Address - Phone:212-423-6801
Mailing Address - Fax:212-423-8807
Practice Address - Street 1:1901 1ST AVE
Practice Address - Street 2:1215A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7404
Practice Address - Country:US
Practice Address - Phone:212-423-6801
Practice Address - Fax:212-423-8807
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY198847207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology