Individual
BRANDON MICHAEL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 BROADWAY ST # 102, BUFFALO, NY 14204-1541
(929) 712-7183
Mailing address
1317 PORTAGE RD, NIAGARA FALLS, NY 14301-1154
(929) 712-7183
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
171000000
AS
171000000X
Military Health Care Provider
Primary
171000000
—
171000000X
Military Health Care Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230548361
AARP MEDICARE RX PREFERRED UHC RRB PART D
NC
Enumeration date
04/08/2025
Last updated
01/30/2026
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