Jacob, Mini

Jacob, Mini is an individual health care provider with primary practice located at 11910 Liberty Ave , South Richmond Hill NY 11419-2002. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Jacob, Mini can be contacted via phone (718) 835-2542.

Contact Information

Primary practice address
11910 Liberty Ave South Richmond Hill NY 11419-2002
Phone: (718) 835-2542
Fax: (718) 641-3044
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 045036-1 New York

Profile Details

NPI number 1841473220
LBN Legal business name Jacob, Mini
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2007
Last updated Mar 15th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841473220 NPPES
New York MEDICAID 00270439

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