Provider Demographics
NPI:1912026667
Name:NORTH COUNTRY FAMILY HEALTH & MEDICINE, PC
Entity Type:Organization
Organization Name:NORTH COUNTRY FAMILY HEALTH & MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JURASITS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-521-0323
Mailing Address - Street 1:4 HIGH CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1204
Mailing Address - Country:US
Mailing Address - Phone:631-509-6888
Mailing Address - Fax:631-509-6895
Practice Address - Street 1:4 HIGH CT
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-1204
Practice Address - Country:US
Practice Address - Phone:631-521-0323
Practice Address - Fax:631-521-0323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty