Individual
ADAM JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
425 E 61ST ST FL 10, NEW YORK, NY 10065-8722
(646) 962-4250
Mailing address
235 W END AVE, APARTMENT 16F, NEW YORK, NY 10023-3631
(203) 980-5245
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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