Individual
DR. JACOB SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 SYOSSET WOODBURY RD, WOODBURY, NY 11797-1215
(516) 476-4071
Mailing address
333 CEDAR ST, PO BOX 208059, NEW HAVEN, CT 06520
(203) 785-4092
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
67573
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2017
Last updated
05/13/2021
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