Provider Demographics
NPI:1861191264
Name:MATHISZIG-LEE, JAKOB FERDINAND (MBBS, FRCA)
Entity type:Individual
Prefix:DR
First Name:JAKOB
Middle Name:FERDINAND
Last Name:MATHISZIG-LEE
Suffix:
Gender:M
Credentials:MBBS, FRCA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:525 E 68TH ST # 124
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH ST # 124
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-8563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ZZ717394207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7293874OtherGENERAL MEDICAL COUNCIL