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1154555761
TRAVIS LEE JACOBS
BROOKLYN, NY
NPI
1154555761
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 1086052)
Enumeration Date
2009-05-11
Last Update Date
2022-08-27
Business Address
TRAVIS LEE JACOBS Physician Assistant
1523 VOORHIES AVE
BROOKLYN, NY 11235-3912
Phone number: 718-808-9101
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Mailing Address
TRAVIS LEE JACOBS Physician Assistant
354 LIBERTY WAY APT 3B
BROOKLYN, NY 11209-8528
Phone number: 315-778-8749
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