Individual
INESSA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
6108 WOODSIDE AVE, WOODSIDE, NY 11377-3543
(718) 505-1700
Mailing address
2350 WATERS EDGE DR APT 5I, BAYSIDE, NY 11360-2208
(917) 656-2027
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
008299
NY
152W00000X
Optometrist
56008299
NY
Other
Enumeration date
06/14/2015
Last updated
05/10/2018
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