| Organization Name: | JOHN ERIC JACOBY MD PC |
| NPI Number: | 1134379571 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN E JACOBY (PRESIDENT/OWNER) |
| Mailing Address: | 466 Main St New Rochelle |
| State: | NY US |
| Postal Code: | 108016431 |
| Phone Number: | 9146331020 |
| Fax Number: | 9146333235 |
| NPI Enumeration Date: | 09/23/2008 |
| NPI Last Update Date: | 09/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 109045 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |