Individual
LAUREN TAYLOR JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 E 77TH ST, NEW YORK, NY 10075-1850
(212) 434-3400
Mailing address
72 DALE AVE, STATEN ISLAND, NY 10306-1919
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
01/25/2018
Last updated
08/16/2023
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