Provider Demographics
NPI:1083658389
Name:ALAN R. JACOBS, M.D., P.C.
Entity Type:Organization
Organization Name:ALAN R. JACOBS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-888-0002
Mailing Address - Street 1:120 E 56TH ST
Mailing Address - Street 2:SUITE 1040
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3607
Mailing Address - Country:US
Mailing Address - Phone:212-888-0002
Mailing Address - Fax:212-888-1899
Practice Address - Street 1:120 E 56TH ST
Practice Address - Street 2:SUITE 1040
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3607
Practice Address - Country:US
Practice Address - Phone:212-888-0002
Practice Address - Fax:212-888-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1837992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY502551Medicare ID - Type UnspecifiedPROVIDER NUMBER
NYWEK481Medicare ID - Type UnspecifiedGROUP NUMBER
NYF61517Medicare UPIN