Individual
BETTY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 E 86TH ST, NEW YORK, NY 10028-3115
(212) 427-6940
(212) 831-5694
Mailing address
251 E 86TH ST, NEW YORK, NY 10028-3115
(212) 427-6940
(212) 831-5694
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
053658-1
NY
Other
Enumeration date
02/05/2010
Last updated
02/05/2010
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