Individual
EMILY ROSE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-8000
Mailing address
2100 MACK BLVD FL 4, ALLENTOWN, PA 18103-5622
(484) 629-2282
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA062975
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA062975
STATE LICENSE
PA
Enumeration date
10/06/2021
Last updated
11/01/2021
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