Provider Demographics
NPI:1295757201
Name:KRAVITZ, JAY A (MD , MPH)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:A
Last Name:KRAVITZ
Suffix:
Gender:M
Credentials:MD , MPH
Other - Prefix:
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Mailing Address - Street 1:500 WESTOVER DR # 17016
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-8941
Mailing Address - Country:US
Mailing Address - Phone:518-399-1184
Mailing Address - Fax:
Practice Address - Street 1:7 WESTBURY DR
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-9126
Practice Address - Country:US
Practice Address - Phone:518-399-1184
Practice Address - Fax:518-517-2396
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY162556207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10001105OtherCDPHP
NY7602574OtherAETNA
NY000401946001OtherBSNENY
NY47341OtherGHI/HMO
NY692041OtherEMPIRE BC
NY01060168Medicaid
NY060804000043OtherFIDELIS
NY08134OtherMVP
NY200213OtherSENIOR WHOLE HEALTH
NY08134OtherMVP
NY060804000043OtherFIDELIS