| Paul G. Jacoby Lcsw, P.l.l.c. | |
|
36 Winthrop St Rochester NY 14607-1326 | |
| (585) 460-0066 | |
| (585) 460-0038 |
| Full Name | Paul G. Jacoby Lcsw, P.l.l.c. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 36 Winthrop St, Rochester, New York |
| Authorized Official Name and Position | Paul G Jacoby (OWNER) |
| Authorized Official Contact | 5854600066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul G. Jacoby Lcsw, P.l.l.c. 36 Winthrop St Rochester NY 14607-1326 Ph: (585) 460-0066 | Paul G. Jacoby Lcsw, P.l.l.c. 36 Winthrop St Rochester NY 14607-1326 Ph: (585) 460-0066 |
| NPI Number | 1316671456 |
|---|---|
| Provider Enumeration Date | 07/14/2022 |
| Last Update Date | 07/14/2022 |
| Certification Date | 06/16/2022 |
| Medicare PECOS PAC ID | 0749659977 |
|---|---|
| Medicare Enrollment ID | O20221212000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316671456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Paul G Jacoby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063708360 PECOS PAC ID: 3971972100 Enrollment ID: I20221212000227 |
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