Organization
JESU JACOB, D.O., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESU JACOB D.O. (OWNER/ CEO)
(631) 670-7800
Entity
Organization
Contact information
Practice address
66 HARNED RD, COMMACK, NY 11725-3527
(631) 670-7800
(631) 670-7798
Mailing address
66 HARNED RD, COMMACK, NY 11725-3527
(631) 670-7800
(631) 670-7798
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
235713
NY
Other
Enumeration date
08/16/2011
Last updated
03/03/2016
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