Individual
DR. BRADFORD ELLIOT JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
30 HEMPSTEAD AVE, SUITE 143, ROCKVILLE CENTRE, NY 11570-4033
(516) 764-3223
(877) 546-7612
Mailing address
30 HEMPSTEAD AVE, SUITE 143, ROCKVILLE CENTRE, NY 11570-4033
(516) 764-3223
(877) 546-7612
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8097
NY
Other
Enumeration date
11/10/2006
Last updated
06/20/2008
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