Individual
MR. MICHAEL JACOBS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
351 ATLANTIC AVE, MASSAPEQUA PARK, NY 11762-1627
(516) 459-8365
Mailing address
351 ATLANTIC AVE, MASSAPEQUA PARK, NY 11762-1627
(516) 459-8365
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/31/2014
Last updated
01/31/2014
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