Organization
JACOBS RADIOLOGY PLLC
Active
Organization
JACOBS RADIOLOGY PLLC
Active
Other names
South Shore Vein and Image-Guided Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID T JACOBS MD (OWNER)
(516) 865-1234
Entity
Organization
Contact information
Practice address
24 MAPLE AVE STE 2, ROCKVILLE CENTRE, NY 11570-4259
(516) 865-1234
Mailing address
24 MAPLE AVE STE 2, ROCKVILLE CENTRE, NY 11570-4259
(516) 865-1234
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
257302-1
NY
Other
Enumeration date
04/26/2017
Last updated
12/31/2020
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