Individual
MARIANNE JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
375 MOUNT PLEASANT AVE, WEST ORANGE, NJ 07052-2750
(973) 322-6900
(973) 322-6999
Mailing address
48 SYCAMORE LN, ROSLYN HEIGHTS, NY 11577-2522
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
25MB11494800
NJ
2080P0205X
Pediatric Endocrinology Physician
Primary
297526
NY
Other
Enumeration date
08/15/2017
Last updated
10/06/2022
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