Jacobs, Laurie G

Jacobs, Laurie G is an individual health care provider with primary practice located at Medical Arts Pavilion 3400 Bainbridge Avenue, Bronx NY 10467. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Jacobs, Laurie G can be contacted via phone (866) 633-8255.

Contact Information

Primary practice address
Medical Arts Pavilion 3400 Bainbridge Avenue Bronx NY 10467
Phone: (866) 633-8255
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 25MA09916100 New Jersey

Profile Details

NPI number 1093890865
LBN Legal business name Jacobs, Laurie G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Dec 9th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093890865 NPPES
New Jersey MEDICAID 0530328

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