NPIMap

Organization Active NPI

Enj Medical PC

  • Family Medicine Physician
  • Lawrence, NY
National Provider Identifier
1912311960
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
267245 Issued in NY
Legal business name
ENJ MEDICAL PC
Practice address
275 Rockaway Tpke
Suite a
Lawrence, NY 11559-1272
Phone
(516) 400-9302
Fax
(516) 400-9309
NPI assigned
Jun 18, 2014
Last updated
Aug 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Authorized official

Name
David Martin Jacobson, DONPI 1306154703
Title
Owner
Phone
(347) 262-2427

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
Family Medicine Physician 207Q00000X 267245 NY Primary

Addresses

Primary practice location

275 Rockaway Tpke
Suite a
Lawrence, NY 11559-1272

Mailing address

206 Avery PL
Cedarhurst, NY 11516-1805
Phone (347) 262-2427

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1403049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1912311960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 AVERY PL",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115161805",
            "telephone_number": "347-262-2427",
            "fax_number": "516-400-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 ROCKAWAY TPKE",
            "address_2": "SUITE A",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591272",
            "telephone_number": "516-400-9302",
            "fax_number": "516-400-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENJ MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-262-2427",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "267245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.