Organization
ROBERT JACOBSON SURGICAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARION FERRARO (OWNER)
(914) 241-4887
Entity
Organization
Contact information
Practice address
359 E MAIN ST, MOUNT KISCO, NY 10549-3028
(914) 241-4887
(914) 241-1634
Mailing address
359 E MAIN ST, MOUNT KISCO, NY 10549-3028
(914) 241-4887
(914) 241-1634
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
17043
NY
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
Primary
17043
NY
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00570076
—
NY
01
—
ANC1857
OXFORD
—
01
—
B26671
BCBS
—
Enumeration date
06/20/2005
Last updated
11/02/2011
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