Individual
CASSIDY NICOLE JACOBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-0100
Mailing address
7 BROOKFIELD LN, SOUTH SETAUKET, NY 11720-1444
(631) 708-9673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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