Individual
JEMI JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
059937-1
NY
Other
Enumeration date
02/20/2017
Last updated
08/21/2019
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