Individual
ANDREA JAKUBOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
1506 LUCILLE LN, SAINT CLOUD, MN 56303-0431
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
294893
NY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
294893
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2015
Last updated
02/08/2022
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