Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACOB HENRY ETTINGER, PA
ActiveMR. JACOB HENRY ETTINGER, PA is a Surgical Physician Assistant healthcare provider located in GREAT NECK, New York. NPI 1063441517 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · GREAT NECK, NY
Registration Details
- NPI Number
- 1063441517
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 30, 2006 (20.083670760924 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
009528 (NY)009528 (NY)
Practice Information
- Address
-
21 CANTERBURY RDAPARTMENT #3GREAT NECK, NY, 110212123Browse NY providers · Browse ZIP 11021
- Phone
- 5165706015
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Other Surgical Physician Assistant Providers in GREAT NECK, NY
| Name | Credential | NPI |
|---|---|---|
| HEATHER HURD | PA | 1518193770 |
| SUZAN SHIFTEH | PA | 1295063246 |
| SUNDEEP KAUR SINGH | PA | 1750672556 |
| MRS. EVA M. TACZANOWSKI BERSIN | P.A. | 1164703872 |
| MICHELLE STEWART | PA-C | 1003225194 |
| NANCY TANG | PA | 1497394662 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.