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Individual

DR. JESU JACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
66 HARNED RD, COMMACK, NY 11725-3527
(631) 670-7800
(631) 670-7798
Mailing address
PO BOX 304, COMMACK, NY 11725-0304
(631) 670-7800
(631) 670-7798

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
1021
AL
207X00000X
Orthopaedic Surgery Physician
Primary
235713
NY

Other

Enumeration date
04/24/2008
Last updated
03/03/2016
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