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NPI Code Detail

MEDICARE: DR. ELIZABETH ELKA JACOBS-PINSON

MEDICARE: DR. ELIZABETH ELKA JACOBS-PINSON
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
1103T00000XPsychologist8717NY
2103T00000XPsychologist5212NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
134949OTHERNYNATIONAL REGISTER FOR HEALTH SERVICE PROVIDERS IN PSYCHOLOGY
29717OTHERNYPSYCHOLOGY LICENSE

General Provider Information

NPI Number : 1235363946
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH ELKA JACOBS-PINSON
Provider Business Mailing Address
First Line : 1398 CARROLL ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11213-4404
Country : US
Telephone Number : 917-324-2386
Fax Number : 718-692-3865
Provider Business Practice Location Address
First Line : 1398 CARROLL ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11213-4404
Country : US
Telephone Number : 917-324-2386
Fax Number : 718-692-3865
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2009
Last Update Date : 10/19/2021

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