Individual
ALIZA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
240 E 38TH ST FL 17, NEW YORK, NY 10016-2708
(516) 581-6404
Mailing address
14127 70TH AVE APT 2, FLUSHING, NY 11367-2055
(516) 581-6404
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
024315
NY
Other
Enumeration date
11/05/2021
Last updated
11/05/2021
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