Jerry Jacob
Medical Specialty
Professional ID
- NPI: 1538571799
- PECOS ID: 9234452038
- Enrollment ID: I20141231001850
- Credential(MD, DO, DPM):
- Medical School: Columbia University College Of Physicians And Surgeons
- Medical School Graduation Year: 2014
Hospital Service
- Hospital CCN1: 330107
- Business Name (LBN)1: Peconic Bay Medical Center
- Hospital CCN2: 330246
- Business Name (LBN)2: St Charles Hospital
- Hospital CCN3: 330185
- Business Name (LBN)3: John T Mather Memorial Hospital Of Port Jefferson
Medical Practices
- Organization Name: Long Island Anesthesia Physicians Llp
- Group Practice ID assigned by PECOS: 7113825381
- Number of Group Practice member: 70
Location
- Address1: 75 N Country Rd
- Address2:
- City: Port Jefferson
- State: New York
- Zip Code: 11777
- Phone Number: (631)736-4064
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS):
- Used Electronic health record (EHR):