Individual
DR. DAN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
550 PINETOWN RD, STE 350, FORT WASHINGTON, PA 19034-2605
(215) 643-0200
(215) 643-9844
Mailing address
550 PINETOWN RD, STE 350, FORT WASHINGTON, PA 19034-2605
(215) 643-0200
(215) 643-9844
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
OS002982L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00784063
—
PA
Enumeration date
03/19/2007
Last updated
06/12/2012
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