Provider Demographics
NPI:1578657466
Name:JACOBSON, JESSICA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYNN
Last Name:JACOBSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:ROOM 4W1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-263-6438
Mailing Address - Fax:212-263-8284
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:ROOM 4W1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-263-6438
Practice Address - Fax:212-263-8284
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY204256207ZB0001X, 207ZP0102X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine