Individual
JACOB L ACKERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 UTICA AVE, BROOKLYN, NY 11234
(718) 968-8700
(718) 968-8743
Mailing address
1901 UTICA AVE, BROOKLYN, NY 11234
(718) 968-8700
(718) 968-8743
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
112574
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00203892
—
NY
01
—
0147830001
NHIC
NY
01
—
180029308
RAILROAD MEDICARE
NY
Enumeration date
09/15/2006
Last updated
04/03/2012
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