Provider Demographics
NPI:1831342765
Name:JACOBI MEDICAL CENTER
Entity type:Organization
Organization Name:JACOBI MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, DEPARTMENT OF INTERN
Authorized Official - Prefix:MISS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:718-918-5643
Mailing Address - Street 1:532 E 82ND ST
Mailing Address - Street 2:APT 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7124
Mailing Address - Country:US
Mailing Address - Phone:646-620-7997
Mailing Address - Fax:
Practice Address - Street 1:532 E 82ND ST
Practice Address - Street 2:APT 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7124
Practice Address - Country:US
Practice Address - Phone:646-620-7997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital