Organization
HILLSIDE MEDICAL & REHABILITATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JACOBSON M.D. (OWNER)
(718) 308-7267
Entity
Organization
Contact information
Practice address
144-34 HILLSIDE AVE, QUEENS, NY 11435
(718) 308-7267
Mailing address
3 OAKLEAF CT, HUNTINGTON, NY 11743-6053
(718) 308-7267
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
183866-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2700367
GHI
—
01
—
2I2972
EMPIRE BLUE CROSS AND BLUE SHIELD
—
Enumeration date
01/21/2009
Last updated
03/03/2009
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