Individual
LAURIAN JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2281 82ND ST, BROOKLYN, NY 11214-2603
(718) 621-0336
(718) 621-0339
Mailing address
895 CHERRY LN, N WOODMERE, NY 11581-2722
(718) 621-0336
(718) 621-0339
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
166878
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01043970
—
NY
01
—
12E342
MEDICARE
NY
Enumeration date
06/25/2006
Last updated
03/09/2010
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