Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MISS STACY JACOB
ActiveMISS STACY JACOB is a Physician Assistant healthcare provider located in STATEN ISLAND, New York. NPI 1104333178 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · STATEN ISLAND, NY
Registration Details
- NPI Number
- 1104333178
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 29, 2017 (8.6476264930875 yrs)
- Last Updated
- Feb 2, 2026
- Licenses
-
329541-1 (NY)25MP00995000 (NJ)
Practice Information
- Address
-
475 SEAVIEW AVESTATEN ISLAND, NY, 103053436Browse NY providers · Browse ZIP 10305
- Phone
- 7182669000
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in STATEN ISLAND, NY
| Name | Credential | NPI |
|---|---|---|
| ELAINA M CAPORALE | PA-C | 1275524043 |
| CLARE A BEAGEN-MCHUGH | PA | 1295718856 |
| MRS. WENDY ALEXANDRA SIMONS | PHYSICIAN ASSISTANT | 1124095328 |
| ROBERT F CARLUCCI | MD | 1386603405 |
| JAMES VINCENT RUSSO | PA | 1194785725 |
| DANIELLE MARIE GRANDNER | PA | 1053371591 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.