Individual
DR. JOSEPH M JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-6106
(315) 464-6117
Mailing address
251 SALINA MEADOWS PKWY STE 100, SYRACUSE, NY 13212-4516
(315) 464-2000
(315) 464-2010
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
11015533A
IN
208800000X
Urology Physician
Primary
290265
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04813154
—
NY
Enumeration date
06/27/2010
Last updated
04/18/2019
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