MEDICARE: BEN ZION JACOBS M.D. P.C.

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	208800000X	Urology Physician

General Provider Information

NPI Number	:	1417637034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEN ZION JACOBS M.D. P.C.

Provider Business Mailing Address
First Line	:	1648 E 14TH ST STE 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1175
Country	:	US
Telephone Number	:	718-336-6886
Fax Number	:	718-336-3945

Provider Business Practice Location Address
First Line	:	1648 E 14TH ST STE 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1175
Country	:	US
Telephone Number	:	718-336-6886
Fax Number	:	718-336-3945

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BEN ZION JACOBS
Credential	:	MD
Telephone Number	:	718-336-6886

Provider Enumeration Date	:	07/19/2023
Last Update Date	:	07/19/2023

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