Organization
ENJ MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MARTIN JACOBSON DO (OWNER)
(347) 262-2427
Entity
Organization
Contact information
Practice address
275 ROCKAWAY TPKE, SUITE A, LAWRENCE, NY 11559-1272
(516) 400-9302
(516) 400-9309
Mailing address
206 AVERY PL, CEDARHURST, NY 11516-1805
(347) 262-2427
(516) 400-9309
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
267245
NY
Other
Enumeration date
06/18/2014
Last updated
08/11/2014
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