Provider Demographics
NPI:1184073256
Name:J. ALEXANDER JARBATH D.P.M., P.C.
Entity type:Organization
Organization Name:J. ALEXANDER JARBATH D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:JARBATH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-378-2305
Mailing Address - Street 1:7 SURREY LN
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3521
Mailing Address - Country:US
Mailing Address - Phone:917-378-2305
Mailing Address - Fax:516-538-0361
Practice Address - Street 1:7 SURREY LN
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3521
Practice Address - Country:US
Practice Address - Phone:917-378-2305
Practice Address - Fax:516-538-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005380213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU62597Medicare UPIN