Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK Z NUSSBAUM, MD
ActiveJACK Z NUSSBAUM, MD is a Family Medicine healthcare provider located in LAKE RONKONKOMA, New York. NPI 1346242690 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · LAKE RONKONKOMA, NY
Registration Details
- NPI Number
- 1346242690
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 1, 2005 (21.056208359263 yrs)
- Last Updated
- Jul 8, 2007
- License
-
165161 (NY)
Practice Information
- Address
-
388 HAWKINS AVESTE 1LAKE RONKONKOMA, NY, 117794280Browse NY providers · Browse ZIP 11779
- Phone
- 6315888460
- Fax
- 6315888480
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in LAKE RONKONKOMA, NY
| Name | Credential | NPI |
|---|---|---|
| MANUEL R ROSALES | MD | 1487656740 |
| DR. DAVID I HAUER | MD | 1518969880 |
| ROBERT FREDERICK MAZZEO | MD | 1043240534 |
| DR. BHANUMATHY VINAYAGASUNDARAM | M.D. | 1841201282 |
| ROBERT ANDREW TUFANO | D.O. | 1851442966 |
| KHADIGA AHMED | DO | 1053817296 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.