MEDICARE: MR. STEVEN KENNETH JACOBS M.D.

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	207T00000X	Neurological Surgery Physician	60170107	NY

General Provider Information

NPI Number	:	1518957182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN KENNETH JACOBS M.D.

Provider Business Mailing Address
First Line	:	4 LAFAYETTE CT
Second Line	:
City	:	FISHKILL
State	:	NY
Zip	:	12524-3036
Country	:	US
Telephone Number	:	845-896-9200
Fax Number	:	845-896-3262

Provider Business Practice Location Address
First Line	:	4 LAFAYETTE CT
Second Line	:
City	:	FISHKILL
State	:	NY
Zip	:	12524-3036
Country	:	US
Telephone Number	:	845-896-9200
Fax Number	:	845-896-3262

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	03/10/2014

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