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General NPI Number Information
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NPI Number | 1710423249
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Entity Type | Organization
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Legal Business Name | WEST HEMPSTEAD PEDIATRICS
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Dates
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Enumeration Date | 01/08/2017
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Last Update Date | 01/08/2017
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Provider Practice Location Address
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Address Line | 304 CHESTNUT ST
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-2423
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Country | US
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Telephone | 516-500-1200
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Fax | 516-486-1200
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Provider Business Mailing Address
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Address Line | 304 CHESTNUT ST
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-2423
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Country | US
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Telephone | 516-500-1200
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Fax | 516-486-1200
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHARI JACOBS
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Credential | M.D.
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Telephone | 516-500-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 215569
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License Number State | NY
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