Individual
GARY JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
684 ALLEN ST, SYRACUSE, NY 13210-2664
(315) 472-2777
(315) 685-0831
Mailing address
684 ALLEN ST, SYRACUSE, NY 13210-2664
(315) 472-2777
(315) 685-0831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
003952
NY
Other
Enumeration date
04/14/2006
Last updated
07/08/2007
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