Individual
JONATHAN JAKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
258 HIGH AVE, NYACK, NY 10960-2407
(845) 353-1441
(845) 353-1987
Mailing address
258 HIGH AVE, NYACK, NY 10960-2407
(845) 353-1441
(845) 353-1987
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
127804
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000003945
GHI HMO #
NY
01
—
0008550
GHI PPO #
NY
05
—
00278120
—
NY
01
—
0542164
AETNA HMO #
NY
01
—
0D4695
HEALTHNET #
NY
01
—
1000017625
AFFINITY #
NY
01
—
103945
WELLCARE #
NY
01
—
127804
CONNECTICARE #
NY
01
—
337001
EMPIRE BCBS #
NY
01
—
4061574
AETNA PPO #
NY
01
—
696487
MVP #
NY
01
—
KN6788
ATLANTIS HEALTH PLAN #
NY
01
—
RP102
OXFORD #
NY
Enumeration date
10/18/2005
Last updated
03/27/2018
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