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Contact Information

JAIRO A VEDRA
2446 WASHINGTON AVE
OCEANSIDE, NY11572
 Phone: 516-536-0946
 Fax: 516-536-4495
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for JAIRO A VEDRA · (Male)

NPI Number 1124080965
Status Active
Credentials
Entity Individual
Enumeration date 04/05/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 226851
  • NY Medicaid 02624679
Hospital affiliation(s)
  • GOOD SAMARITAN HOSPITAL MEDICAL CENTER - (Acute Care)
    1000 MONTAUK HIGHWAY
    WEST ISLIP, NY 11795
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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