Individual
GLADY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
267 AVERY LN STE 300, ROME, NY 13441-4240
(315) 356-7390
(315) 356-7393
Mailing address
PO BOX 2000, EAST SYRACUSE, NY 13057-4500
(315) 362-5129
(315) 362-5179
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
003788-1
NY
2084N0600X
Clinical Neurophysiology Physician
003788-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03351764
—
NY
Enumeration date
05/03/2007
Last updated
05/12/2023
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