Provider Demographics
NPI:1942615604
Name:WHITE, JONATHON MATTHEW (MBCHB)
Entity Type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:MATTHEW
Last Name:WHITE
Suffix:
Gender:M
Credentials:MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 FORT WASHINGTON AVENUE, 6TH FLOOR
Mailing Address - Street 2:INTERVENTIONAL CARDIOLOGY, COLUMBIA UNIVERSITY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-2708
Mailing Address - Fax:
Practice Address - Street 1:161 FORT WASHINGTON AVENUE, 6TH FLOOR
Practice Address - Street 2:INTERVENTIONAL CARDIOLOGY, COLUMBIA UNIVERSITY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-2708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP92648207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology