Basic Information
| Provider Information | |||||||||
| NPI: | 1205879582 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINSLOW | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | ALLEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1345 RXR PLZ FL 13 | ||||||||
| Address2: | |||||||||
| City: | UNIONDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115561301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164530435 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 HOSPITAL ROAD | ||||||||
| Address2: | MEDICAL CENTER | ||||||||
| City: | PATCHOGUE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316872953 | ||||||||
| FaxNumber: | 6106176280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 228046 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.