Provider Demographics
NPI:1720178148
Name:COMPAS, JEAN CLAUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN CLAUDE
Middle Name:
Last Name:COMPAS
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 1:255 EASTERN PARKWAY
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238
Mailing Address - Country:US
Mailing Address - Phone:718-636-8291
Mailing Address - Fax:
Practice Address - Street 1:255 EASTERN PARKWAY
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238
Practice Address - Country:US
Practice Address - Phone:718-636-8291
Practice Address - Fax:718-636-8667
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141141207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1720178148OtherNPI
NY00710494Medicaid
NYAC9555636OtherDEA
NY1720178148OtherNPI
NYCOQQ23Medicare UPIN
NYAC9555636OtherDEA