Individual
DR. JACOB DONOHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
30 E 40TH ST RM 608, NEW YORK, NY 10016
(212) 251-0044
Mailing address
66 SEABREEZE LN, BRISTOL, RI 02809-1552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
059871
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2017
Last updated
07/27/2018
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