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Individual

ALYSHA JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
171 W 73RD ST APT 4, NEW YORK, NY 10023-2947
(917) 445-9566
(646) 304-0305
Mailing address
171 W 73RD ST APT 4, NEW YORK, NY 10023-2947
(917) 445-9566
(646) 304-0305

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
005955
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01984087
NY
Enumeration date
02/02/2006
Last updated
05/08/2025
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