Provider Demographics
NPI:1336240647
Name:GEWIRTZ, JULES MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULES
Middle Name:MARTIN
Last Name:GEWIRTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NEW HEMPSTEAD ROAD
Mailing Address - Street 2:SUITE D
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956
Mailing Address - Country:US
Mailing Address - Phone:845-362-1630
Mailing Address - Fax:845-362-1641
Practice Address - Street 1:500 NEW HEMPSTEAD ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956
Practice Address - Country:US
Practice Address - Phone:845-362-1630
Practice Address - Fax:845-362-1641
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135645208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics