Provider Demographics
NPI:1538138409
Name:JEFFREY AINSPAN M.D., P.C.
Entity type:Organization
Organization Name:JEFFREY AINSPAN M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AINSPAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-788-5272
Mailing Address - Street 1:72 EILEEN DR
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-2806
Mailing Address - Country:US
Mailing Address - Phone:201-327-8704
Mailing Address - Fax:
Practice Address - Street 1:308A E 15TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4001
Practice Address - Country:US
Practice Address - Phone:212-505-5790
Practice Address - Fax:212-505-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155051207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1000003251OtherAFFINITY
155051-H20OtherHEALTHFIRST
990121OtherCIGNA
155051OtherHIP
70D571OtherEMPIRE BCBS
P852474OtherOXFORD
000000092884OtherGHI HMO
0014933OtherGHI PPO
AINSJ064OtherGREAT WEST ONE HEALTHPLAN
11112286OtherMULTIPLAN
4C5623OtherHEALTHNET
171185OtherELDERPLAN
5317347OtherAETNA PPO
2340394OtherAETNA HMO
31496OtherHIP CMO
5317347OtherAETNA PPO
1000003251OtherAFFINITY
AINSJ064OtherGREAT WEST ONE HEALTHPLAN