Individual
DR. ERIC JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5822 BROADWAY, BRONX, NY 10463-2454
(718) 549-3185
(718) 884-5002
Mailing address
3 OAK LEAF COURT, HUNTINGTON, NY 11743
(718) 308-6189
(718) 884-5002
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
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/29/2007
Last updated
09/05/2010
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