Provider Demographics
NPI:1770245797
Name:JACOBS, DANIEL HAROLD (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HAROLD
Last Name:JACOBS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 N GREENWICH RD
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-2311
Mailing Address - Country:US
Mailing Address - Phone:914-202-0700
Mailing Address - Fax:914-462-3444
Practice Address - Street 1:5 N GREENWICH RD
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-2311
Practice Address - Country:US
Practice Address - Phone:914-690-7629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046227-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist