Individual
DR. JACOB WIDROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1803 JASON DR, CINNAMINSON, NJ 08077-1553
(914) 582-6218
Mailing address
1803 JASON DR, CINNAMINSON, NJ 08077-1553
(914) 582-6218
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MT187253
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102236820
—
PA
Enumeration date
05/01/2007
Last updated
02/05/2012
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