Individual
ZACHARY COLIN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
492 MONTAUK HWY, EAST MORICHES, NY 11940-1347
(631) 638-2900
(631) 878-8083
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-0650
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
279031
NY
Other
Enumeration date
03/27/2009
Last updated
05/15/2015
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