Individual
JACOB DANIEL CANAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1650 GRAND CONCOURSE, BRONX, NY 10457-7679
(718) 992-7669
Mailing address
1650 GRAND CONCOURSE, BRONX, NY 10457-7679
(718) 992-7669
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
327964
NY
Other
Enumeration date
03/22/2021
Last updated
09/03/2024
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