Individual
JORDAN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1136 ROUTE 9W S, NYACK, NY 10960-4826
(212) 517-1855
Mailing address
PO BOX 233, NYACK, NY 10960-0233
(212) 517-1855
Taxonomy
Speciality
Code
Description
License number
State
163WS0121X
Plastic Surgery Registered Nurse
Primary
717202
NY
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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