Individual
DR. MARIANN C. JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
430 EAST 34TH STREET, NEW YORK, NY 10016
(866) 733-7698
(212) 562-6019
Mailing address
432 ARGYLE RD, MINEOLA, NY 11501-1014
(847) 208-3277
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036.35602
IL
208000000X
Pediatrics Physician
Primary
316056
NY
208000000X
Pediatrics Physician
62609-20
WI
208M00000X
Hospitalist Physician
62609
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07137497
—
NY
05
—
1811301799
—
WI
Enumeration date
06/18/2014
Last updated
03/19/2024
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