Jacoby, Mel S

Jacoby, Mel S is an individual health care provider with primary practice located at 1555 Long Pond Rd , Rochester NY 14626-4122. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Jacoby, Mel S can be contacted via phone (585) 241-6400.

Contact Information

Primary practice address
1555 Long Pond Rd Rochester NY 14626-4122
Fax: (585) 241-6505
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 104185 New York

Profile Details

NPI number 1891784021
LBN Legal business name Jacoby, Mel S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Dec 4th, 2009 - about 17 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 1891784021 NPPES
New York MEDICAID 01196767

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