# EASTERN MEDICAL CONSULTING PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235608035
- **Authorized official:** GLENN JAKOBSEN DO (MEDICAL DIRECTOR)
- **Authorized official phone:** (347) 744-8605

## Contact information

- **Practice address:** 330 W 58TH ST, NEW YORK, NY 10019-1827
- **Practice address phone:** (212) 765-6470
- **Practice address fax:** (212) 333-7346
- **Mailing address:** 25 WILLET AVE, HICKSVILLE, NY 11801-1637
- **Mailing address phone:** (347) 744-8605
- **Mailing address fax:** (516) 935-3140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2018
- **Last updated:** 11/21/2018