Individual
BORIS JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22004 LINDEN BLVD, CAMBRIA HEIGHTS, NY 11411-1628
(718) 712-3358
Mailing address
441 ROGERS AVE APT 3R, BROOKLYN, NY 11225-3484
(718) 541-9199
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/09/2023
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