Organization
EASTERN MEDICAL CONSULTING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN JAKOBSEN DO (MEDICAL DIRECTOR)
(347) 744-8605
Entity
Organization
Contact information
Practice address
330 W 58TH ST, NEW YORK, NY 10019-1827
(212) 765-6470
(212) 333-7346
Mailing address
25 WILLET AVE, HICKSVILLE, NY 11801-1637
(347) 744-8605
(516) 935-3140
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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