Jacobs, Jonathan M.

Jacobs, Jonathan M. is an individual health care provider with primary practice located at 5100 W Taft Rd Suite 2A, Liverpool NY 13088-3807. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Jacobs, Jonathan M. can be contacted via phone (315) 452-2555.

Contact Information

Primary practice address
5100 W Taft Rd Suite 2A Liverpool NY 13088-3807
Phone: (315) 452-2555
Fax: (315) 452-2559
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 174853 New York

Profile Details

NPI number 1114919917
LBN Legal business name Jacobs, Jonathan M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Mar 12th, 2008 - about 16 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 1114919917 NPPES
New York MEDICAID 01428151

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