Jemi Jacob
Dentist, General Practice in Bronx, NY. Individual provider (NPI-1).
NPI number1174062467
StatusActive
Last updated in NPPESAug 21, 2019
Details
- NPI
- 1174062467
- Entity type
- Individual (NPI-1)
- Name
- Jemi Jacob
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 20, 2017
- Last updated
- Aug 21, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 059937-1 | NY | Yes |
Practice location
111 E 210th StBronx, NY 10467-2401
Phone 718-920-4321
Mailing address
111 E 210th StBronx, NY 10467-2401
Phone 718-920-4321
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