Individual
DR. KIRSTEN E JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1530 ROUTE 9, WAPPINGERS FALLS, NY 12590-4131
(845) 297-2511
(845) 297-4993
Mailing address
16 WEST BRIDGE ST, SAUGERTIES, NY 12477
(845) 246-3000
(845) 246-7622
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
206698
NY
207Q00000X
Family Medicine Physician
Primary
206698 1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191949
GHI
—
05
—
01995239
—
NY
01
—
080164854
RAILROAD MEDICARE
—
01
—
080324000053
FIDELIS
—
01
—
123349
GHI HMO
—
01
—
6012114
MVP
—
01
—
9X9381
EMPIRE BLUE CROSS
—
Enumeration date
06/29/2006
Last updated
09/20/2012
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