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
Phone: (609) 927-4235
Fax: (609) 927-5590
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1659394484 | NPPES |
New Jersey | MEDICAID | 2261308 |
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