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NPI Code Detail

MEDICARE: TODD JACOBSON OTR/L

MEDICARE: TODD JACOBSON OTR/L
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
1225X00000XOccupational Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356811954
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD JACOBSON OTR/L
Provider Business Mailing Address
First Line : 66 BROAD ST
Second Line :
City : WESTFIELD
State : MA
Zip : 01085-2927
Country : US
Telephone Number : 413-562-5464
Fax Number :
Provider Business Practice Location Address
First Line : 66 BROAD ST
Second Line :
City : WESTFIELD
State : MA
Zip : 01085-2927
Country : US
Telephone Number : 413-562-5464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2018
Last Update Date : 01/16/2019

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Directions to “ TODD JACOBSON OTR/L” Practice Location

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