Organization
PEDIATRIC NEUROLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD I JACOBSON MD (MD)
(914) 358-0188
Entity
Organization
Contact information
Practice address
755 NORTH BROADWAY, STE. 540, SLEEPY HOLLOW, NY 10591
(866) 289-4595
Mailing address
755 NORTH BROADWAY, STE. 540, SLEEPY HOLLOW, NY 10591
(866) 289-4595
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
157834
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00608975
—
NY
Enumeration date
06/29/2007
Last updated
04/04/2012
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