NPI 1053138628

Bruce Jacobs

Practitioner Contractor Commack, NY

Practice location

Address: 53 Somerset Dr, Commack, NY 11725-1637
Phone: (347) 213-1474

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1053138628
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Sep 2024
Record last updated: 24 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.