Individual
MR. JACOB DAVID URBAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA, CSCS, FMSC
Contact information
Practice address
2745 COLONIAL AVE, MERRICK, NY 11566-4906
(718) 801-4618
Mailing address
2745 COLONIAL AVE, MERRICK, NY 11566-4906
(718) 801-4618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
011200
NY
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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