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Justin Jacob
NPI 1538077649 · on the registry since 2026 · sole proprietor
Practice
- Address
- 3921 Wilder Ave
Bronx, NY 10466 - Phone
- (914) 364-6983
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-09-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York