Provider Demographics
NPI:1962643304
Name:MAJOR MEDICINE, PC
Entity Type:Organization
Organization Name:MAJOR MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEISSBLUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-934-1800
Mailing Address - Street 1:3019 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:718-934-1800
Mailing Address - Fax:718-891-5208
Practice Address - Street 1:3019 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5111
Practice Address - Country:US
Practice Address - Phone:718-934-1800
Practice Address - Fax:718-891-5208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty