Individual
ADAM JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
309895
NY
208200000X
Plastic Surgery Physician
80024
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
309895
NEW YORK MEDICAL LICENSE
NY
01
—
80024
CONNECTICUT MEDICAL LICENSE
CT
Enumeration date
05/06/2015
Last updated
03/24/2025
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