| Doctor Name: | DR. JESSE JAMPOL |
| NPI Number: | 1558786749 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 075885 |
| Business Practice Address: | 400 E 56th St Apt. 18d New York, NY - 100224147 |
| Business Phone Number: | 2126894055 |
| Business Fax Number: | 2126894055 |
| Mailing Address: | 400 E 56th St, Apt. 18d NEW YORK |
| State: | NY |
| Postal Code: | 100224147 |
| Phone Number: | 2126894055 |
| Fax Number: | 2126894055 |
| NPI Enumeration Date: | 02/24/2014 |
| NPI Last Update Date: | 02/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 075885 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |