MEDICARE: DR. JACOB NACHEMAN PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	027086	NY

General Provider Information

NPI Number	:	1215724307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB NACHEMAN PHD

Provider Business Mailing Address
First Line	:	416 E 83RD ST APT G2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-6133
Country	:	US
Telephone Number	:	908-380-4529
Fax Number	:

Provider Business Practice Location Address
First Line	:	416 E 83RD ST APT G2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-6133
Country	:	US
Telephone Number	:	908-380-4529
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2025
Last Update Date	:	04/22/2025

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