MEDICARE: OFER JACOBOWITZ M. D.,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	207YX0602X	Otolaryngic Allergy Physician	207577-1	NY
2	207YS0012X	Sleep Medicine (Otolaryngology) Physician	207511-1	NY
3	207Y00000X	Otolaryngology Physician	207511-1	NY

General Provider Information

NPI Number	:	1285617381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OFER JACOBOWITZ M. D.,PHD

Provider Business Mailing Address
First Line	:	660 WHITE PLAINS RD FL 4
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5139
Country	:	US
Telephone Number	:	914-984-2546
Fax Number	:	914-425-0480

Provider Business Practice Location Address
First Line	:	18 E 48TH ST FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-1014
Country	:	US
Telephone Number	:	646-868-4300
Fax Number	:	646-868-4495

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	04/02/2019

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