Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 191673 | NY |
NPI | 1053467886 |
---|---|
Provider Name | Elizabeth Jacobson |
First Address | New York, NY 10065-8722 |
Second Address | New York, NY 10065-8722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 10/11/2011 |