Provider Demographics
NPI:1447218532
Name:JACOBS, STEVEN ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANDREW
Last Name:JACOBS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1345 RXR PLZ FL 13
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11556-1301
Mailing Address - Country:US
Mailing Address - Phone:516-435-0435
Mailing Address - Fax:646-846-3283
Practice Address - Street 1:560 MERRICK RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5445
Practice Address - Country:US
Practice Address - Phone:516-858-2373
Practice Address - Fax:516-858-2387
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2019-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY214758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1790936854OtherNY FAMILY PRACTICE PHYSICIANS P.C ; NPI: 1790936854 TAX ID: 262744378