Active NPI
Martin Jacob
- Pharmacist
- New York, NY
National Provider Identifier
1659730604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 060515
- Practice address
- 102 W 116TH St
New York, NY 10026-2500 - Phone
- (212) 666-8100
- NPI assigned
- Feb 18, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 060515 | NY | Primary |
Addresses
Primary practice location
102 W 116TH St
New York, NY 10026-2500
Mailing address
77 Roosevelt St
Closter, NJ 07624-2710
Phone (201) 767-1777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060515 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harlem RX Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- New York, NY
- NPI 1689976953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455753600000",
"number": "1659730604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 ROOSEVELT ST",
"city": "CLOSTER",
"state": "NJ",
"postal_code": "076242710",
"telephone_number": "201-767-1777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 W 116TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100262500",
"telephone_number": "212-666-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "MARTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-18",
"last_updated": "2016-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "060515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.