Individual
DR. MARK STEVEN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 N UNION ST, SUITE 101, ROCHESTER, NY 14607-1345
(585) 232-2560
(585) 232-6446
Mailing address
30 N UNION ST, SUITE 101, ROCHESTER, NY 14607-1345
(585) 232-2560
(585) 232-6446
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
206578-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01735840
—
NY
01
—
0308
EXCELLUS BLUE SHIELD
NY
01
—
10102CR
PREFERRED CARE
NY
01
—
4303445
AETNA
NY
Enumeration date
08/02/2006
Last updated
07/08/2007
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