# ROBERT JACOBSON SURGICAL PHARMACY INC.

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

## Provider details

- **NPI number:** 1568564979
- **Authorized official:** ABRAAM GERGIS (PRESIDENT)
- **Authorized official phone:** (914) 241-4887

## Contact information

- **Practice address:** 359 EAST MAIN STREET, MT KISCO, NY 10549
- **Practice address phone:** (914) 241-4887
- **Practice address fax:** (914) 241-7041
- **Mailing address:** 359 EAST MAIN STREET, MT KISCO, NY 10549
- **Mailing address phone:** (914) 241-4887
- **Mailing address fax:** (914) 241-7041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 017043 | NY | Yes |

## Other

- **Enumeration date:** 09/05/2006
- **Last updated:** 04/07/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00570076 | — | NY |
| 01 | — | 3371159 | NCPDP | — |