Provider Demographics
NPI:1376786004
Name:VERNON, JEFFREY ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:VERNON
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:125 DELANCEY ST APT 804
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5193
Mailing Address - Country:US
Mailing Address - Phone:917-725-0762
Mailing Address - Fax:905-963-1689
Practice Address - Street 1:125 DELANCEY ST APT 804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5193
Practice Address - Country:US
Practice Address - Phone:917-725-0762
Practice Address - Fax:905-963-1689
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2024-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2526712084P0800X, 2084P0800X
MEDO25852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry