Individual
BRIAN JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 5TH AVE, LAPAROSCOPIC SURGICAL CENTER, NEW YORK, NY 10028-0130
(212) 879-6677
(212) 650-9981
Mailing address
1010 5TH AVE, LAPAROSCOPIC SURGERY CENTER, NEW YORK, NY 10028-0130
(212) 879-6677
(212) 650-9981
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
219514
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02588205
—
NY
Enumeration date
02/23/2006
Last updated
07/08/2007
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