Individual
DEBRA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4823
(212) 774-2834
Mailing address
PO BOX 29234, NEW YORK, NY 10087-9234
(212) 774-2834
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F336066-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03407370
—
NY
Enumeration date
10/27/2009
Last updated
04/26/2021
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