Individual
DR. MRIDULA A JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1729 BURRSTONE RD, NEW HARTFORD, NY 13413-1001
(315) 798-1434
(315) 798-1461
Mailing address
1729 BURRSTONE RD, NEW HARTFORD, NY 13413-1001
(315) 798-1434
(315) 798-1461
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
295165
NY
Other
Enumeration date
06/30/2015
Last updated
07/11/2024
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