Individual
JACOB TYLER DEUBLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
101 HOSPITAL RD, PATCHOGUE, NY 11772-4870
(540) 287-6371
Mailing address
14 WALL ST FL 9, NEW YORK, NY 10005-2178
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
031046
NY
Other
Enumeration date
08/03/2023
Last updated
02/15/2024
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