MEDICARE: JODI JACOBS DC PLLC

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	261QH0100X	Health Service Clinic/Center	011379	NY

General Provider Information

NPI Number	:	1487164885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JODI JACOBS DC PLLC

Provider Business Mailing Address
First Line	:	10 GLADSTONE PL
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10703-1149
Country	:	US
Telephone Number	:	914-623-8722
Fax Number	:	914-476-6400

Provider Business Practice Location Address
First Line	:	3407 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-5704
Country	:	US
Telephone Number	:	718-325-1658
Fax Number	:	718-653-1658

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	DR. JODI L JACOBS
Credential	:	DC
Telephone Number	:	914-476-6500

Provider Enumeration Date	:	10/11/2017
Last Update Date	:	12/17/2025

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