| Doctor Name: | JAY W ENEMAN |
| NPI Number: | 1003811811 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 132580 |
| Business Practice Address: | 780 Long Beach Blvd Long Beach, NY - 115612238 |
| Business Phone Number: | 5168979000 |
| Business Fax Number: | 5168978656 |
| Mailing Address: | Po Box 330, WOODMERE |
| State: | NY |
| Postal Code: | 115980330 |
| Phone Number: | 5168979000 |
| Fax Number: | 5168978656 |
| NPI Enumeration Date: | 06/17/2005 |
| NPI Last Update Date: | 06/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/20/2006 |
| NPI Reactivation Date: | 03/31/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225000000X |
| License Number: | 132580 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Orthotic Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |