Nelson, Jack Andrew

Nelson, Jack Andrew is an individual health care provider with primary practice located at 240 W Montauk Hwy , Hampton Bays NY 11946-3510. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Nelson, Jack Andrew can be contacted via phone (631) 728-1300.

Contact Information

Primary practice address
240 W Montauk Hwy Hampton Bays NY 11946-3510
Phone: (631) 728-1300
Fax: (631) 728-5165
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 0429341 New York

Profile Details

NPI number 1629166590
LBN Legal business name Nelson, Jack Andrew
Credentials OMFS
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Mar 10th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1629166590 NPPES
New York MEDICAID 01548470

Popular Providers