Individual
JACOB IBROOK TOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
335 BOYLSTON ST, NEWTON, MA 02459-2871
(617) 566-3223
Mailing address
335 BOYLSTON ST, NEWTON, MA 02459-2871
(617) 566-3223
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
288000
MA
207YS0123X
Facial Plastic Surgery Physician
Primary
288000
MA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
303409
NY
Other
Enumeration date
05/19/2015
Last updated
04/26/2023
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