Individual
DR. BARRY L. JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
135-14 JEWEL AVE, FLUSHING, NY 11367
(718) 997-6453
(718) 793-8956
Mailing address
29 N AIRMONT RD STE 22, SUFFERN, NY 10901-4242
(845) 369-3703
(845) 369-3183
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
045485
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01649187
—
NY
Enumeration date
08/30/2006
Last updated
01/16/2023
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