Provider Demographics
NPI:1275627556
Name:JACOBS, LINDA H (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:H
Last Name:JACOBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:50 UNDERHILL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3418
Mailing Address - Country:US
Mailing Address - Phone:516-921-2122
Mailing Address - Fax:516-921-0670
Practice Address - Street 1:50 UNDERHILL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3418
Practice Address - Country:US
Practice Address - Phone:516-921-2122
Practice Address - Fax:516-921-0670
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY217901208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics