Individual
LESLIE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5141 BROADWAY, NEW YORK, NY 10034-1159
(212) 305-4098
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
122509-1
NY
Other
Enumeration date
07/19/2006
Last updated
08/21/2012
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