Jarrod Anderson
Individual provider Active NPI Contractor · Brooklyn, NY
NPI 1992499529 · NPPES record last updated Jun 6, 2023
Key facts
- NPI
- 1992499529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 1764 Union St Apt 3B
Brooklyn, NY 11213-5099 - Phone
- (813) 900-6486
- NPI assigned
- Jun 6, 2023
- 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)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
1764 Union St Apt 3B
Brooklyn, NY 11213-5099
Mailing address
1764 Union St Apt 3B
Brooklyn, NY 11213-5099
Phone (813) 900-6486
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2023. 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.