Individual
JACOB C NWOSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
602 LIBERTY PL, SICKLERVILLE, NJ 08081-5700
(856) 776-7540
Mailing address
700 LIBERTY PL, SICKLERVILLE, NJ 08081-5715
(856) 776-7540
(856) 776-7512
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP225100
NJ
Other
Enumeration date
11/05/2009
Last updated
01/21/2017
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