Tristate Physical Medicine & Rehabilitation, P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

183866 Issued in NY

Legal business name

TRISTATE PHYSICAL MEDICINE & REHABILITATION, P.C.

Practice address

5822 Broadway
Bronx, NY 10463-2454

Phone

(718) 549-3185

Fax

(718) 884-5002

NPI assigned

Jul 17, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric Jacobson, M.D.NPI 1477699692

Title

Owner

Phone

(631) 367-0177

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Jacobson, MD

  • Physical Medicine & Rehabilitation Physician
  • Bronx, NY
  • NPI 1477699692
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247788800000",
    "number": "1295965739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5822 BROADWAY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104632454",
            "telephone_number": "718-549-3185",
            "fax_number": "718-884-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5822 BROADWAY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104632454",
            "telephone_number": "718-549-3185",
            "fax_number": "718-884-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTATE PHYSICAL MEDICINE & REHABILITATION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2009-07-17",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-367-0177",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "183866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shyana Trinidad
• Triple J'S Car Services Inc.
• Sai Sidhvija Tripurana
• Tristar Pharmacy Inc.
• Tristate Optometry PLLC
• George Trister, M.D.
• Triumph Medical Supply LLC
• Heather Anne Trivedi, M.D.
• Kalyani R Trivedi, MD
• Prachi Dilipkumar Trivedi, M.B.B.S.

• Physical Medicine & Rehabilitation Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.