National Provider Identifier
Michael R Jordan, M.D.
Michael R Jordan, M.D. is listed in the NPPES registry with a primary specialty of Pediatrics Physician in Newark, NY and a listed phone number of (315) 359-2660.
Profile Overview
- NPI
- 1053323469
- Provider Type
- Individual
- Primary Specialty
- Pediatrics Physician
- Enumeration Date
- August 13, 2006
- Last Updated
- July 08, 2007
Practice Location
- 1200 Driving Park Ave
- Newark, NY 14513-1057
Phone: (315) 359-2660
Specialties
- Pediatrics Physician (208000000X)
Full Record
- NPI
- 1053323469
- Entity Type
- Individual
- Last Name
- Jordan
- First Name
- Michael
- Middle Name
- R
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 1200 Driving Park Ave
- Mailing City
- Newark
- Mailing State
- NY
- Mailing ZIP Code
- 14513-1057
- Mailing Country
- US
- Mailing Phone
- (315) 359-2660
- Mailing Fax
- (315) 359-2635
- Practice Street Address
- 1200 Driving Park Ave
- Practice City
- Newark
- Practice State
- NY
- Practice ZIP Code
- 14513-1057
- Practice Country
- US
- Practice Phone
- (315) 359-2660
- Practice Fax
- (315) 359-2635
- Enumeration Date
- August 13, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatrics Physician (208000000X)
- Other Identifiers
- 00596429 (NY)