Jeffrey Kenneth Auerbach
Individual provider Active NPI Specialist · Watertown, NY
NPI 1679637110 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1679637110
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 62028782 (NY)
- Practice address
- 19472 US Route 11
Watertown, NY 13601-5387 - Phone
- (315) 782-6126
- Fax
- (315) 782-3816
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62028782 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 62028782 | NY | Yes |
Addresses
Primary practice location
19472 US Route 11
Watertown, NY 13601-5387
Mailing address
19472 US Route 11
Watertown, NY 13601-5387
Phone (315) 782-6126
Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.