Provider Demographics
NPI:1962711754
Name:JACOB, YOCHEVED (MA,OTR)
Entity type:Individual
Prefix:MRS
First Name:YOCHEVED
Middle Name:
Last Name:JACOB
Suffix:
Gender:F
Credentials:MA,OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1381 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5427
Mailing Address - Country:US
Mailing Address - Phone:917-612-5232
Mailing Address - Fax:
Practice Address - Street 1:1510 39TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4414
Practice Address - Country:US
Practice Address - Phone:718-854-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006745-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics