Judd Jacob, PT, CLS is a
Technician, Pathology - Clinical Laboratory Director, Non-physician based in Yonkers, New York. Judd Jacob is licensed to practice in New York (license number 014999) and his current practice location is
340 S Broadway, Yonkers, New York. He can be reached at his office (for appointments etc.) via phone at
(914) 968-5125.
NPI number for Judd Jacob is 1407152333 and his current mailing address is 174 Grand St, White Plains, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1407152333.
Healthcare Provider's Profile
| Full Name | Judd Jacob |
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| Gender | Male |
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| Speciality | Technician, Pathology - Clinical Laboratory Director, Non-physician |
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| Location | 340 S Broadway, Yonkers, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1407152333
- Provider Enumeration Date: 02/10/2011
- Last Update Date: 04/13/2016
Medical Identifiers
Medical identifiers for Judd Jacob such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407152333 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | 032031 (New York) | Secondary |
| 247ZC0005X | Technician, Pathology - Clinical Laboratory Director, Non-physician | 014999 (New York) | Primary |
| 247ZC0005X | Technician, Pathology - Clinical Laboratory Director, Non-physician | 226448 (* (Not Available)) | Secondary |
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. Judd Jacob is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Judd Jacob, PT, CLS
174 Grand St,
White Plains, NY 10601-4803
Ph: (914) 328-8077 | Judd Jacob, PT, CLS
340 S Broadway,
Yonkers, NY 10705-2049
Ph: (914) 968-5125 |
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