Jacobson, Lawrence Marc

Jacobson, Lawrence Marc is an individual health care provider with primary practice located at 40 Park Ave Ste 4, New York NY 10016-3467. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Jacobson, Lawrence Marc can be contacted via phone (212) 981-9812.

Contact Information

Primary practice address
40 Park Ave Ste 4 New York NY 10016-3467
Phone: (212) 981-9812
Fax: (212) 981-9813
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 191576 New York

Profile Details

NPI number 1184627465
LBN Legal business name Jacobson, Lawrence Marc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Dec 14th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184627465 NPPES
New York Other 410A13 EMPIRE BLUE CROSS BLUE SHIELD
New York MEDICAID 01618395 EMPIRE BLUE CROSS BLUE SHIELD
New York Other 2003139571 EMPIRE BLUE CROSS BLUE SHIELD
New York Other 410A11 EMPIRE BLUE CROSS BLUE SHIELD

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