| Jacob H Jacoby Medical Pc | |
|
100 Route 59 Ste 103 Suffern NY 10901-4927 | |
| (845) 697-0000 | |
| (718) 387-6429 |
| Full Name | Jacob H Jacoby Medical Pc |
|---|---|
| Speciality | Psychologist |
| Location | 100 Route 59 Ste 103, Suffern, New York |
| Authorized Official Name and Position | Jacob Jacoby (CEO) |
| Authorized Official Contact | 8456970000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob H Jacoby Medical Pc 100 Route 59 Ste 103 Suffern NY 10901-4927 Ph: (845) 697-0000 | Jacob H Jacoby Medical Pc 100 Route 59 Ste 103 Suffern NY 10901-4927 Ph: (845) 697-0000 |
| NPI Number | 1316597008 |
|---|---|
| Provider Enumeration Date | 09/16/2019 |
| Last Update Date | 09/16/2019 |
| Medicare PECOS PAC ID | 3476969585 |
|---|---|
| Medicare Enrollment ID | O20210315001225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316597008 | NPI | - | NPPES |
| Provider Name | Jacob H Jacoby |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174648232 PECOS PAC ID: 5395861363 Enrollment ID: I20101120000015 |
| Provider Name | Kathleen S Kubera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538478961 PECOS PAC ID: 3375722762 Enrollment ID: I20110201000755 |
| Provider Name | Raul Figueroa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083778088 PECOS PAC ID: 1850301839 Enrollment ID: I20120223000369 |
| Provider Name | Tanisha Castellanos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710251335 PECOS PAC ID: 0143523779 Enrollment ID: I20160114001944 |
| Provider Name | Shira Andrusier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144833765 PECOS PAC ID: 7911315502 Enrollment ID: I20210420002239 |
| Provider Name | Blima Schneebalg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679100291 PECOS PAC ID: 9335558808 Enrollment ID: I20210513000786 |
| Provider Name | Malka Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194289512 PECOS PAC ID: 6103226014 Enrollment ID: I20210615001697 |
| Provider Name | Janine E Estupinan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205922648 PECOS PAC ID: 8527458751 Enrollment ID: I20211202001812 |
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