DR. SUSAN VIVIAN JACOB (NPI# 1467675819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467675819 |
Entity Type | Individual |
Full Name | DR. SUSAN VIVIAN JACOB |
Other Name | SUSAN VIVIAN JAKOB |
Credential | PHD |
Practice Address |
14 Vanderventer Ave Port Washington NY 11050-3737 |
Practice Telephone | 5169443786 |
Mailing Telephone | 5169443786 |
Enumeration Date | 2007-04-11 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
0077981 | NY | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | LICENSE NUMBER | 0077981 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821468257 | Susan Jacob | Nurse Practitioner | 212 Angela Ln, Stafford, TX 77477 | 2015-09-28 |
1699865881 | Susan C Jacob | Allergy & Immunology | 801 Alma St, Tomball, TX 77375 | 2006-10-16 |
1245246503 | Susan M. Jacob | Counselor | 1101 Dove St, Suite 160, Newport Beach, CA 92660-2839 | 2006-07-31 |
1356964431 | Susan Jacob | Student in an Organized Health Care Education/Training Program | 3459 5th Ave Ste 9, Pittsburgh, PA 15213-3236 | 2020-05-22 |
1306315130 | Susan Jacob | Nurse Practitioner | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2018-11-22 |
1801134390 | Susan Biji Jacob | Nurse Practitioner | 4400 N Lincoln Blvd, Oklahoma City, OK 73105-5104 | 2013-01-18 |
1487991246 | Susan Jacob | Pharmacist | 5473 Nw Saint James Dr, Port Saint Lucie, FL 34983-3444 | 2013-01-12 |
1568685436 | Susan Jacob | Nurse Practitioner | 710 W 168th Street, New York, NY 10032-2699 | 2007-04-10 |
1538207220 | Susan Jacob | Family Medicine | 231 Albert Sabin Way, Cincinnati, OH 45267-2827 | 2007-02-02 |
1508951872 | Susan Jacob | Family Medicine | 55 Brendon Way, Suite 100, Zionsville, IN 46077-1955 | 2006-10-04 |
Street Address |
14 VANDERVENTER AVE |
City | PORT WASHINGTON |
State | NY |
Zip Code | 11050-3737 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073558631 | Ashraf M Estafan | Dentist | 14 Vanderventer Ave, Suite 215, Port Washington, NY 11050-3759 | 2006-06-18 |
1306071964 | Anita E Shashoua | Dentist | 14 Vanderventer Ave, Suite 212, Port Washington, NY 11050-3737 | 2009-05-26 |
1417181017 | Robert Steven Popkin | Dentist | 14 Vanderventer Ave, Port Washington, NY 11050-3737 | 2009-05-11 |
1790924942 | Robin Perlberg | Acupuncturist | 14 Vanderventer Ave, Suite 145, Port Washington, NY 11050-3737 | 2009-02-11 |
1104096908 | Rhonda Mae Yoss-kaplan | Psychologist | 14 Vanderventer Ave, Suite 103, Port Washington, NY 11050-3737 | 2008-03-07 |
1265629778 | Daniela Spector | Dentist | 14 Vanderventer Ave, Suite 120, Port Washington, NY 11050-3737 | 2007-09-28 |
1508063264 | Paul Dominic Verdi | Dentist | 14 Vanderventer Ave, Suite 140, Port Washington, NY 11050-3737 | 2007-06-27 |
1003942020 | Joseph T Shen | Internal Medicine | 14 Vanderventer Ave, Suite 130-138, Port Washington, NY 11050-3737 | 2007-02-26 |
1063580967 | Bill Stephen Wald | Dentist | 14 Vanderventer Ave, Ste 120, Port Washington, NY 11050 | 2006-12-01 |
1710060223 | Long Island Oral & Maxillofacial Surgery, PC | Dentist | 14 Vanderventer Ave, Ste 260, Port Washington, NY 11050-3737 | 2006-10-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144689696 | One-care Physical Therapy Pllc | Physical Therapist | 45 B Dunwood Rd, Port Washington, NY 11050 | 2016-02-12 |
1720472525 | Dominique Neebe | Specialist | 141 Middleneck Road, Sands Point, NY 11050 | 2015-03-19 |
1902237316 | Cheryl Goldfarb | Speech-Language Pathologist | 11 Leeds Drive, Port Washington, NY 11050 | 2013-12-11 |
1467722454 | Robert Cerpa | Psychologist | 6 Morewood Oaks, Manorhaven Elementary School, Port Washington, NY 11050 | 2012-01-06 |
1043515828 | Tak Wai Chau | Social Worker | 36 Rockwood Ave, Port Washingto, NY 11050 | 2011-01-25 |
1073823167 | Donna Lee Kosina | Occupational Therapist | 10 Maple Dr., Port Washington, NY 11050 | 2010-10-07 |
1962710467 | Alicia Marie Leporati | Counselor | 9 Graywood Rd, Port Washington, NY 11050 | 2010-09-17 |
1164747630 | Thomas Young Suh | Pharmacist | 100 Habor View Drive #630, Port Washington, NY 11050 | 2010-03-29 |
1376778142 | Ellen J Satloff | Social Worker | 14 Terrace Drive, Port Washington, NY 11050 | 2009-05-22 |
1376707547 | Port Washington Dental Associates | Clinic/Center | 18 Haven Ave, Port Washington, NY 11050 | 2008-07-16 |
Find all providers in zip 11050 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639544968 | Anita Sethi | Psychologist | 40 Pleasant Ave, Port Washington, NY 11050-2202 | 2015-12-11 |
1104096908 | Rhonda Mae Yoss-kaplan | Psychologist | 14 Vanderventer Ave, Suite 103, Port Washington, NY 11050-3737 | 2008-03-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659996718 | Marlee Schwartz | Psychologist | 351 Manville Rd Ste 104&109, Pleasantville, NY 10570-2152 | 2020-06-14 |
1063031946 | Gwen Rachel Gordon Rothschild | Psychologist | 250 E Hartsdale Ave Ste 23, Hartsdale, NY 10530-3574 | 2020-04-10 |
1922630631 | Juliet Lisa Collingwood | Psychologist | 471 13th St, Brooklyn, NY 11215-5206 | 2020-02-11 |
1578102513 | Anne Austin Weissenberger | Psychologist | 144 King St, Chappaqua, NY 10514-3499 | 2019-12-21 |
1114560398 | Alison Melville Locker | Psychologist | 375 Greenwich St Ste 812, New York, NY 10013-2376 | 2019-10-21 |
1417502543 | Norma Linda Doft | Psychologist | 295 Central Park W Ofc 4a, New York, NY 10024-3021 | 2019-08-06 |
1194387456 | Allison Canfield | Psychologist | Developmental & Behavioral Pediatrics 601 Elmwood Ave, Rochester, NY 14642-0001 | 2019-07-07 |
1043870728 | Sarah Donovan | Psychologist | 5151 Fieldstone Trl, Canandaigua, NY 14424-8245 | 2019-06-16 |
1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
1063983757 | Miriam Shields | Psychologist | 13681 71st Rd, Flushing, NY 11367-1942 | 2018-12-06 |
Find all providers with the same taxonomy |
City | PORT WASHINGTON |
Zip Code | 11050 |
Please comment or provide details below to improve the information on DR. SUSAN VIVIAN JACOB.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.