Provider Demographics
NPI:1376854380
Name:JACOBOWITZ, BEATRICE (OT)
Entity Type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:
Last Name:JACOBOWITZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 E 73RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6602
Mailing Address - Country:US
Mailing Address - Phone:347-492-3861
Mailing Address - Fax:347-492-3860
Practice Address - Street 1:3521 AVENUE S
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4827
Practice Address - Country:US
Practice Address - Phone:718-336-3832
Practice Address - Fax:718-336-2392
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008597-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist