Organization
COSMETIC SURGERY OF NEW YORK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ALAN JACOBS M.D. (SURGEON)
(631) 473-7070
Entity
Organization
Contact information
Practice address
4616 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2563
(631) 473-7070
(631) 331-2654
Mailing address
4616 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2563
(631) 473-7070
(631) 331-2654
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A400036602
PTAN
NY
Enumeration date
05/31/2007
Last updated
07/21/2022
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