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STACY JACOB
Physician Assistant
NPI: 1104333178IndividualAccepts Medicare
Specialties, Licenses & Credentials
Licensed Practical Nurse
Licensed Practical Nurse
Code: 164W00000X
329541-1(NY)
Physician AssistantPrimary
Physician Assistant
Code: 363A00000X
25MP00995000(NJ)
CMS Specialties
PrimaryPHYSICIAN ASSISTANT
Education
OTHER
Class of 2022
Contact & Hours
- Address
- 475 SEAVIEW AVE
STATEN ISLAND, NY 10305 - Phone
- (718) 266-9000
Quick Facts
- NPI
- 1104333178
- Entity Type
- Individual
- Gender
- Female
- Medicare
- Accepted
- Specialties
- 3
- Locations
- 1
- Years in Practice
- 4
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