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General NPI Number Information
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NPI Number | 1841677192
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Entity Type | Individual
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Provider Name | ADAM JACOBY MD
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Gender | Male
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 425 E 61ST ST FL 10
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City | NEW YORK
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State | NY
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Zip | 10065-8722
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Country | US
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Telephone | 646-962-4250
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Fax |
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Provider Business Mailing Address
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Address Line | 235 W END AVE APARTMENT 16F
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City | NEW YORK
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State | NY
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Zip | 10023-3631
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Country | US
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Telephone | 203-980-5245
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 80024
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 309895
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License Number State | NY
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