Organization
PAIN MANAGEMENT & REHABILITATIVE PHYSICAL MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURIAN JACOBY MD (PRESIDENT)
(718) 621-0336
Entity
Organization
Contact information
Practice address
2281 82ND ST, BROOKLYN, NY 11214-2603
(718) 621-0336
(718) 621-0339
Mailing address
895 CHERRY LN, VALLEY STREAM, NY 11581-2722
(718) 621-0336
(718) 621-0339
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
166878
NY
Other
Enumeration date
02/16/2007
Last updated
04/17/2014
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