Mr Jacob Henry Ettinger, PA in Great Neck, NY - Medicare Physician Assistant

Mr Jacob Henry Ettinger, PA is a medicare enrolled "Physician Assistant - Surgical" in Great Neck, New York. His current practice location is 21 Canterbury Rd, Apartment #3, Great Neck, New York. You can reach out to his office (for appointments etc.) via phone at (516) 570-6015.

Mr Jacob Henry Ettinger is licensed to practice in New York (license number 009528) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063441517.

Contact Information

	Mr Jacob Henry Ettinger, PA
	21 Canterbury Rd, Apartment #3, Great Neck, NY 11021-2123
	(516) 570-6015
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Jacob Henry Ettinger
Gender	Male
Speciality	Physician Assistant - Surgical
Location	21 Canterbury Rd, Great Neck, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063441517
Provider Enumeration Date: 06/30/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 3779530571
Enrollment ID: I20050404001101

Medical Identifiers

Medical identifiers for Mr Jacob Henry Ettinger such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063441517	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	009528 (New York)	Primary
363AS0400X	Physician Assistant - Surgical	009528 (New York)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jacob Henry Ettinger is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Jacob Henry Ettinger, PA 21 Canterbury Rd, Apartment #3, Great Neck, NY 11021-2123 Ph: (516) 570-6015	Mr Jacob Henry Ettinger, PA 21 Canterbury Rd, Apartment #3, Great Neck, NY 11021-2123 Ph: (516) 570-6015

Reviews and Comments

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Mr Jacob Henry Ettinger, PA - Medicare Physician Assistant in Great Neck, NY