Organization · NPI-2
Jordan Sudberg MD P.C.
Physical Medicine & Rehabilitation, Pain Medicine · Islandia, NY
NPI number1285033662
StatusActive
Last updated in NPPESNov 1, 2024
Details
- NPI
- 1285033662
- Entity type
- Organization (NPI-2)
- Legal business name
- Jordan Sudberg MD P.C.
- Organization subpart
- No
- Enumeration date
- Aug 21, 2014
- Certification date
- Nov 1, 2024
- Last updated
- Nov 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | 272774 | NY | Yes |
Practice location
1717 Veterans Memorial Hwy Ste 1Islandia, NY 11749-1532
Phone 646-239-8418
Mailing address
50 E 28th St Apt 21dNew York, NY 10016-7980
Phone 646-239-8418
Authorized official
Jordan Sudberg
President
6462398418
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