Provider Demographics
NPI:1881719755
Name:ROWER, JAMIE A
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:A
Last Name:ROWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OMNI CT
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5211
Mailing Address - Country:US
Mailing Address - Phone:845-634-5925
Mailing Address - Fax:845-634-8242
Practice Address - Street 1:2 OMNI CT
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5211
Practice Address - Country:US
Practice Address - Phone:845-634-5925
Practice Address - Fax:845-634-8242
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice