Individual
ANTONIETTA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1094 ROBERTA RD, SCHENECTADY, NY 12303-3795
(518) 312-1747
Mailing address
1094 ROBERTA RD, SCHENECTADY, NY 12303-3795
(518) 312-1747
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
326478-1
NY
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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