NPIMap

Organization Active NPI

Long Island Women's Obstetrics and Gynecology PLLC

  • Primary Care Clinic/Center
  • New Hyde Park, NY
National Provider Identifier
1851690788
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
161044 Issued in NY
Legal business name
LONG ISLAND WOMEN'S OBSTETRICS AND GYNECOLOGY PLLC
Practice address
3003 New Hyde Park Rd
Suite 407
New Hyde Park, NY 11042-1206
Phone
(516) 488-8145
Fax
(516) 488-6722
NPI assigned
Mar 17, 2011
Last updated
Mar 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Authorized official

Name
Dr. Jessica R Jacob, M.D.NPI 1871592972
Title
Physcian/Owner Solo LLC Practice
Phone
(516) 488-8145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 161044 NY Primary

Addresses

Primary practice location

3003 New Hyde Park Rd
Suite 407
New Hyde Park, NY 11042-1206

Mailing address

3003 New Hyde Park Rd
Suite 407
New Hyde Park, NY 11042-1206
Phone (516) 488-8145

Other names 1

  • Long Island Women's Obs/gyn Other name

National Provider Directory

National Provider Directory

Locations

3003 New Hyde Park Rd
Ste 407
New Hyde Park, NY 11042
Phone (516) 488-8145

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1851690788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK RD",
            "address_2": "SUITE 407",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421206",
            "telephone_number": "516-488-8145",
            "fax_number": "516-488-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK RD",
            "address_2": "SUITE 407",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421206",
            "telephone_number": "516-488-8145",
            "fax_number": "516-488-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND WOMEN'S OBSTETRICS AND GYNECOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSCIAN/OWNER SOLO LLC PRACTICE",
        "authorized_official_telephone_number": "516-488-8145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "161044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island Women's Obs/gyn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.