| Reena Jacob MD | |
|
20 Squadron Blvd Suite 350 New City NY 10956-5200 | |
| (845) 634-4567 | |
| (845) 634-4564 |
| Full Name | Reena Jacob MD |
|---|---|
| Speciality | Internal Medicine |
| Location | 20 Squadron Blvd, New City, New York |
| Authorized Official Name and Position | Reena J Jacob (OWNER) |
| Authorized Official Contact | 8456344567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reena Jacob MD 20 Squadron Blvd Suite 350 New City NY 10956-5200 Ph: (845) 634-4567 | Reena Jacob MD 20 Squadron Blvd Suite 350 New City NY 10956-5200 Ph: (845) 634-4567 |
| NPI Number | 1114969458 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 08/08/2008 |
| Medicare PECOS PAC ID | 8729001631 |
|---|---|
| Medicare Enrollment ID | O20060106000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114969458 | NPI | - | NPPES |
| 02148603 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Reena J Jacob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720015746 PECOS PAC ID: 1254354160 Enrollment ID: I20060106000091 |
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