Individual
JACOB MCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
180 FORT WASHINGTON AVE FL 2, NEW YORK, NY 10032-3722
(212) 305-8039
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
302820
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2017
Last updated
04/12/2024
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