Individual
JACOB FORD PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 BROADWAY RM 1510, NEW YORK, NY 10018-3368
(212) 262-2850
Mailing address
720 FT WASHINGTON AVE APT 4T, NEW YORK, NY 10040-3725
(917) 699-7954
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
026576
NY
Other
Enumeration date
03/03/2020
Last updated
08/23/2024
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