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NPI Code Detail

MEDICARE: DR. JACOB V GEORGE MD

MEDICARE: DR. JACOB V GEORGE MD
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
1207R00000XInternal Medicine Physician136708NY

General Provider Information

NPI Number : 1679674717
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACOB V GEORGE MD
Provider Business Mailing Address
First Line : 3 NASH PL
Second Line :
City : ARMONK
State : NY
Zip : 10504-2530
Country : US
Telephone Number : 914-273-8216
Fax Number : 718-599-6859
Provider Business Practice Location Address
First Line : 231 S 3RD ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-5601
Country : US
Telephone Number : 718-599-0505
Fax Number : 718-599-6859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 05/27/2011

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