Susannah Jacobi, Ph.d., P.c. | |
59 W 12th St Suite 1e New York NY 10011-8563 | |
(646) 290-8404 | |
Not Available |
Full Name | Susannah Jacobi, Ph.d., P.c. |
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Speciality | Clinic/Center |
Location | 59 W 12th St, New York, New York |
Authorized Official Name and Position | Susannah Gille Jacobi (PRESIDENT) |
Authorized Official Contact | 6462908404 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Susannah Jacobi, Ph.d., P.c. 59 W 12th St Suite 1e New York NY 10011-8563 Ph: (646) 290-8404 | Susannah Jacobi, Ph.d., P.c. 59 W 12th St Suite 1e New York NY 10011-8563 Ph: (646) 290-8404 |
NPI Number | 1215111661 |
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Provider Enumeration Date | 12/20/2007 |
Last Update Date | 12/20/2007 |
Medicare PECOS PAC ID | 3870673130 |
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Medicare Enrollment ID | O20071228000147 |
Identifier | Type | State | Issuer |
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1215111661 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | 015752 (New York) | Primary |
Provider Name | Susannah G Jacobi |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1083837538 PECOS PAC ID: 2062592314 Enrollment ID: I20071228000135 |
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