Individual
DR. JOBY CHACKO JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1411 WOODBOURNE RD, LEVITTOWN, PA 19057-1540
(215) 943-2000
(215) 943-4439
Mailing address
PO BOX 7410725, CHICAGO, IL 60674-0725
(215) 943-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD474033
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT216142
PA
Other
Enumeration date
05/16/2018
Last updated
08/08/2022
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