Doctor Name: | DR. JANE SO |
NPI Number: | 1083938575 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | FS4460274 |
Business Practice Address: | 100 S Jersey Ave Unit 16 East Setauket, NY - 117332036 |
Business Phone Number: | 6316896400 |
Business Fax Number: | 6316895742 |
Mailing Address: | 100 S Jersey Ave Unit 16, EAST SETAUKET |
State: | NY |
Postal Code: | 117332036 |
Phone Number: | 6316896400 |
Fax Number: | 6316895742 |
NPI Enumeration Date: | 03/26/2010 |
NPI Last Update Date: | 06/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | FS4460274 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |