Individual
MITCHEL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
891 NORTHERN BLVD, SUITE 203, GREAT NECK, NY 11021-5334
(516) 773-6300
(516) 796-4700
Mailing address
891 NORTHERN BLVD, STE 203, GREAT NECK, NY 11021-5305
(516) 773-6300
(516) 706-4700
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
180855
NY
Other
Enumeration date
12/11/2006
Last updated
01/24/2019
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