Individual
AMY JAKOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 TEE VIEW CT, MANORVILLE, NY 11949-2939
(631) 874-3032
(631) 874-4105
Mailing address
198 HICKORY GROVE DR, LARCHMONT, NY 10538-1408
(917) 846-7735
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005913-1
NY
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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