Individual
ALICE S JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
697 PATTERSON AVE, FRANKLIN SQUARE, NY 11010-4105
(516) 263-2459
Mailing address
697 PATTERSON AVE, FRANKLIN SQUARE, NY 11010-4105
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F344505
NY
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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