Margaret Rose Jacoby

Individual provider Active NPI Other Technician · Fox Point, WI

NPI 1629323282 · NPPES record last updated Jul 19, 2012

Key facts

NPI
1629323282
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
8003 N Port Washington Rd
Fox Point, WI 53217-2647
Phone
(414) 228-6444
Fax
(414) 228-7005
NPI assigned
Jul 19, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Podiatry, Inc. Past Accepting new patients
Dr. Steven M Waldman S.C. Past
since Jan 1, 2006
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

8003 N Port Washington Rd
Fox Point, WI 53217-2647

Mailing address

3610 Michelle Witmer Memorial Dr
Suite 110
New Berlin, WI 53151-5292
Phone (262) 821-1588

Other providers in Fox Point, WI

All providers in Fox Point, WI · Other Technician in Wisconsin

Sources for this page

Verify at the official NPI Registry.