Individual
DR. MATTHEW DAVID JACOFSKY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
935 NORTHERN BLVD, SUITE 102, GREAT NECK, NY 11021-5309
(516) 487-7116
(516) 829-1731
Mailing address
3941 213TH ST, APT 3, BAYSIDE, NY 11361-2054
(718) 428-9679
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
016733
NY
Other
Enumeration date
05/20/2006
Last updated
07/08/2007
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