Provider Demographics
NPI:1245375856
Name:JOHN J. JASAITIS, M.D., P.C.
Entity type:Organization
Organization Name:JOHN J. JASAITIS, M.D., 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:JULIUS
Authorized Official - Last Name:JASAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-759-5557
Mailing Address - Street 1:303 2ND AVE
Mailing Address - Street 2:SUITE # 20
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2739
Mailing Address - Country:US
Mailing Address - Phone:212-759-5557
Mailing Address - Fax:212-759-0248
Practice Address - Street 1:303 2ND AVE
Practice Address - Street 2:SUITE # 20
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2739
Practice Address - Country:US
Practice Address - Phone:212-759-5557
Practice Address - Fax:212-759-0248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084482-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty