JACOB JACOBY MD (NPI# 1790347243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790347243 |
| Entity Type | Organization |
| Organization Name | JACOB JACOBY MD |
| Other Organization Name | JACOB JACOBY MD PHD |
| Practice Address |
100 Route 59 Ste 103 Suffern NY 10901-4927 |
| Mailing Address |
612 Corporate Way Ste 2m Valley Cottage NY 10989-2027 |
| Practice Telephone | 7183628184 |
| Practice Fax Number | 7183621651 |
| Mailing Telephone | 7183628184 |
| Mailing Fax Number | 7183621651 |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2019-07-05 |
| Authorized Official Name | JACOB JACOBY (OWNER) |
| Authorized Official Telephone | 7183628184 |
| Authorized Official Credential | MD PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02327411 | 05 |
| Other Name | Type Code |
|---|---|
| JACOB JACOBY MD PHD | Doing Business As Name - Organization |
| Street Address |
100 ROUTE 59 STE 103 |
| City | SUFFERN |
| State | NY |
| Zip Code | 10901-4927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316597008 | Jacob H Jacoby Medical PC | Counselor | 100 Route 59 Ste 103, Suffern, NY 10901-4927 | 2019-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895309 | Constance Marie Princiotto | Registered Nurse | J&d Ultracare, 15 Suffern Pl, Suffern, NY 10901 | 2020-09-10 |
| 1376101790 | Tenika Filomena Walters | Licensed Practical Nurse | 15 Suffen Place, Suffen, NY 10901 | 2019-05-31 |
| 1922563261 | Matthew Abel | Dietitian, Registered | 156 Ny-59, A2, Suffern, NY 10901 | 2019-01-31 |
| 1609349422 | Yona Newmark | Behavioral Analyst | 84 Route 59 Suite 102, Suffern, NY 10901 | 2019-01-03 |
| 1235606005 | William M Mazariego | Specialist/Technologist | 5 Tallman Pl, Suffern, NY 10901 | 2018-10-30 |
| 1396237228 | Stephanie N Freer | Registered Nurse | 15 Suffern Pl., Suffern, NY 10901 | 2018-06-06 |
| 1588102669 | Lisa Arcuri | Registered Nurse | 15 Suffern Place Ste A, Suffern, NY 10901 | 2017-02-08 |
| 1801342787 | Maria Castro-cancel | Social Worker | 58 Campbell Avenue, Airmont, NY 10901 | 2016-08-30 |
| 1811341530 | Simone Raven Pringle | Licensed Practical Nurse | 15 Suffern Place, Suite A, Suffern, NY 10901 | 2016-04-19 |
| 1871998666 | Simi Samuel | Specialist | 13 Hillside Ct, Suffern, NY 10901 | 2014-10-23 |
| Find all providers in zip 10901 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245702 | Dial Doc Now Medical Group PC | Clinic/Center | 612 Corporate Way Ste 2m, Valley Cottage, NY 10989-2027 | 2020-11-03 |
| 1477176634 | St. Peter's Health Partners Medical Associates, P.C. | Clinic/Center | 1301 River Street Suite 202, St. Peter's Obgyn At Valatie, Valatie, NY 12184-8696 | 2020-05-22 |
| 1831718196 | Critical Care Medicine Services - New York, P.C. | Clinic/Center | 747 3rd Ave Ste 28b, New York, NY 10017-2803 | 2020-04-15 |
| 1275172280 | Citimedical Services PC | Clinic/Center | 6336 99th St Fl 1, Rego Park, NY 11374-1979 | 2019-12-23 |
| 1225688419 | Artisans Ambulatory Medical Care Pllc | Clinic/Center | 4521 Arthur Kill Rd Fl 2, Staten Island, NY 10309-1315 | 2019-09-19 |
| 1336799295 | Wellness Medical Services of Manhattan PC | Clinic/Center | 51 E 25th St Ste 499, New York, NY 10010-2945 | 2019-09-12 |
| 1174089056 | City Medical of Upper East Side, Pllc | Clinic/Center | 216 E 14th St Ste B, New York, NY 10003-4105 | 2019-02-15 |
| 1770051690 | Seagull Medical Services | Clinic/Center | 105 Norwalk Ave, Staten Island, NY 10314-5658 | 2018-11-08 |
| 1093282329 | The Medical Offices of Occupational Health Resources P C | Clinic/Center | 500 W 33rd St, New York, NY 10001-1301 | 2018-10-24 |
| 1770067738 | Samaritan Hospital of Troy, New York | Clinic/Center | 147 Hoosick St Ste E, Troy, NY 12180-2393 | 2018-09-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.