Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 257815-1 | NY |
N | 208200000X | Surgeon | 257815 | NY |
N | 208600000X | Surgeon | 257815 | NY |
NPI | 1013162619 |
---|---|
Provider Name | Dr. Sharone Marie Jacobs |
First Address | New York, NY 10022-3717 |
Second Address | Miami Beach, FL 33141-3038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2008 |
Last Update Date | 01/10/2010 |