Skip Navigation

Provider Information for 1730278185

  1. Search
  2. Back to Results
  3. NPI View
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

JESSE HACKELL M.D.

Gender: MALE

Individual NPI: 1730278185

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1730278185
Enumeration Date 2006-10-12
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 4 MEDICAL PARK DR SUITE C
POMONA, NY 10970-3516
United States

Phone: 845-362-0202 | Fax: 845-362-1347
View Map External Link
Primary Practice Address 4 MEDICAL PARK DR SUITE C
POMONA, NY 10970-3516
United States

Phone: 845-362-0202 | Fax: 845-362-1347
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NY 00606253
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208000000X - Pediatrics NY 145137