Jacobson, Mark

Jacobson, Mark is an sole proprietor health care provider with primary practice located at 505 Bay Ave Bayside Commons, Sommers Point NJ 08244. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Jacobson, Mark can be contacted via phone (609) 927-4235.

Contact Information

Primary practice address
505 Bay Ave Bayside Commons Sommers Point NJ 08244
Fax: (609) 927-5590
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MB03043900 New Jersey
Allopathic & Osteopathic Physicians / Pediatrics 208000000X OS-003415-L Pennsylvania

Profile Details

NPI number 1659394484
LBN Legal business name Jacobson, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 25th, 2006
Last updated Jul 8th, 2007 - about 17 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 1659394484 NPPES
New Jersey MEDICAID 2261308

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