Individual
DR. JACOB WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1264 SAINT NICHOLAS AVE, NEW YORK, NY 10033-7263
(347) 532-1845
(718) 301-1099
Mailing address
PO BOX 32, NORTHBROOK, IL 60065-0032
(224) 318-0118
(847) 919-4615
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
264822
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04887023
—
NY
Enumeration date
04/04/2010
Last updated
11/29/2018
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