Provider Demographics
NPI:1700052032
Name:CLARENBACH, JACOB JOHANNES (MD)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:JOHANNES
Last Name:CLARENBACH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:111 E 210TH ST
Mailing Address - Street 2:MONTEFIORE MEDICAL CENTER, DIV. OF HOSPITAL MEDICINE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2401
Mailing Address - Country:US
Mailing Address - Phone:718-920-2889
Mailing Address - Fax:718-920-2058
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:MONTEFIORE MEDICAL CENTER, DIV. OF HOSPITAL MEDICINE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-2889
Practice Address - Fax:718-920-2058
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2013-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY265933208M00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology