Individual provider · Type 1 NPI

Dianna Elizabeth Jacob, RPA-C

Surgical Physician Assistant · Bronx, NY

NPI number 1104014737 Active

Practice location

111 E 210th St
Bronx, NY 10467-2401

Call (718) 920-2451 Map

Mailing address

227 E 89th St, Apt 4A
New York, NY 10128-4382

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X007635 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1104014737

Dianna Elizabeth Jacob, RPA-C's National Provider Identifier is 1104014737, issued on Oct 9, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Bronx, NY. The record was last updated on Oct 9, 2007.