Provider Demographics
NPI:1831492800
Name:JAR GROUP MANAGEMENT,INC
Entity Type:Organization
Organization Name:JAR GROUP MANAGEMENT,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:REYFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-998-9890
Mailing Address - Street 1:813 QUENTIN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2220
Mailing Address - Country:US
Mailing Address - Phone:718-998-9890
Mailing Address - Fax:718-998-9891
Practice Address - Street 1:813 QUENTIN RD STE 200
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2220
Practice Address - Country:US
Practice Address - Phone:718-998-9890
Practice Address - Fax:718-998-9891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233144207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400005088Medicare PIN