Individual
JACOB SAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 PATERSON ST, CLINICAL ACADEMIC BUILDING - SUITE 6100, NEW BRUNSWICK, NJ 08901-1962
(732) 235-7733
Mailing address
66 W GILBERT ST, 2ND FLOOR, TINTON FALLS, NJ 07701-4947
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MA02762200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130005904
RR MCR PTAN
NJ
05
—
1903802
—
NJ
Enumeration date
11/22/2006
Last updated
09/21/2011
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