Individual
GLENN JACOBOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 1ST AVE, 6 F, NEW YORK, NY 10016-6402
(212) 263-7311
Mailing address
530 1ST AVE, 6 F, NEW YORK, NY 10016-6402
(212) 263-7311
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
182570
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01737604
—
NY
Enumeration date
09/08/2005
Last updated
04/08/2021
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