Individual
MARTIN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
713 CENTRAL AVE, WOODMERE, NY 11598
(516) 569-3535
Mailing address
713 CENTRAL AVE, WOODMERE, NY 11598
(516) 569-3535
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
NYSTATE011021
NY
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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