Individual
DR. MICHAEL JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 WOODS RD, VALHALLA, NY 22033-3309
(914) 493-2844
(703) 563-6256
Mailing address
11781 LEE JACKSON MEMORIAL HWY, SUITE 550, FAIRFAX, VA 22033-3309
(571) 777-5102
(703) 563-6256
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
279663
NY
390200000X
Student in an Organized Health Care Education/Training Program
MT197673
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04181682
—
NY
Enumeration date
06/18/2010
Last updated
12/14/2015
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