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NPI Code Detail

MEDICARE: LAURIAN JACOBY MD

MEDICARE: LAURIAN JACOBY 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
1208100000XPhysical Medicine & Rehabilitation Physician166878NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112E342OTHERNYMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851327308
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIAN JACOBY MD
Provider Business Mailing Address
First Line : 895 CHERRY LN
Second Line :
City : N WOODMERE
State : NY
Zip : 11581-2722
Country : US
Telephone Number : 718-621-0336
Fax Number : 718-621-0339
Provider Business Practice Location Address
First Line : 2281 82ND ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-2603
Country : US
Telephone Number : 718-621-0336
Fax Number : 718-621-0339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 03/09/2010

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Directions to “ LAURIAN JACOBY MD” Practice Location

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