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Individual

DR. JORDAN M.S. JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
155 WHITE PLAINS RD, SUITE 109, TARRYTOWN, NY 10591-5523
(914) 366-6139
(866) 780-6139
Mailing address
155 WHITE PLAINS RD, SUITE 109, TARRYTOWN, NY 10591-5523

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
248057
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03466075
NY
Enumeration date
05/29/2008
Last updated
01/15/2015
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