Provider Demographics
NPI:1285617381
Name:JACOBOWITZ, OFER (M D,PHD)
Entity type:Individual
Prefix:
First Name:OFER
Middle Name:
Last Name:JACOBOWITZ
Suffix:
Gender:M
Credentials:M D,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:914-425-0480
Practice Address - Street 1:18 E 48TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1014
Practice Address - Country:US
Practice Address - Phone:646-868-4300
Practice Address - Fax:646-868-4495
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207577-1207YX0602X
NY207511-1207YS0012X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400089921Medicare PIN
NYH40815Medicare UPIN
NY6M4331Medicare ID - Type UnspecifiedINDIVIDUAL NUMER