Jerry Jacob, CRNA | |
333 Route 25a, Suite 225, Rocky Point, NY 11778-8556 | |
(631) 744-3671 | |
(631) 744-6205 |
Full Name | Jerry Jacob |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 10 Years |
Location | 333 Route 25a, Rocky Point, New York |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538571799 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 573032 (New York) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 105943 (New York) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Montefiore Medical Center | Bronx, NY | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Montefiore Medical Center | 3779496021 | 2071 |
Entity Name | Rockville Anesthesia Group, Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841303997 PECOS PAC ID: 9537071873 Enrollment ID: O20031104000508 |
Entity Name | Montefiore Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063525152 PECOS PAC ID: 3779496021 Enrollment ID: O20031113000235 |
Entity Name | Long Island Anesthesia Physicians Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952387276 PECOS PAC ID: 7113825381 Enrollment ID: O20040106000103 |
Entity Name | Upstate Anesthesia Services, P.c. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629272141 PECOS PAC ID: 0840383857 Enrollment ID: O20070907000237 |
Entity Name | North Shore - Lij Anesthesiology, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417401266 PECOS PAC ID: 1153602453 Enrollment ID: O20161228001498 |
Mailing Address | Practice Location Address |
---|---|
Jerry Jacob, CRNA 333 Route 25a, Suite 225, Rocky Point, NY 11778-8556 Ph: (631) 744-3671 | Jerry Jacob, CRNA 333 Route 25a, Suite 225, Rocky Point, NY 11778-8556 Ph: (631) 744-3671 |