Individual
JOSEPH JACOBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1384 BROADWAY, NEW YORK, NY 10018-6108
(212) 246-4237
Mailing address
2142 81ST ST, BROOKLYN, NY 11214-2508
(917) 757-6601
Taxonomy
Speciality
Code
Description
License number
State
2471R0002X
Radiation Therapy Radiologic Technologist
Primary
449829
NY
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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