Individual
DR. JACOB H JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
654 AVE C, SUITE 201, BAYONNE, NJ 07002
(201) 339-0323
(201) 339-0349
Mailing address
654 AVE C, SUITE 201, BAYONNE, NJ 07002
(201) 339-0323
(201) 339-0349
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
156653-1
NY
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
46259
NJ
2084P0800X
Psychiatry Physician
156653-1
NY
2084P0800X
Psychiatry Physician
Primary
46259
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088BV1
MEDICARE
NY
Enumeration date
03/20/2007
Last updated
06/16/2010
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