DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. ELLIS JACOBS, PHD

Active Sole Proprietor

Laboratory Management Specialist (Diplomat) · TEANECK, NJ

Registration Details

NPI Number
1720256910
Provider Type
Individual
Gender
Male
NPI Issued
Feb 11, 2008 (18.193804560225 yrs)
Last Updated
Jul 1, 2013
License
JACOE1 (NY)
Sole Proprietor
Yes

Practice Information

Address
540 WYNDHAM RD
TEANECK, NJ, 076662612
Browse NJ providers · Browse ZIP 07666
Phone
2018361518
Fax
2123184699
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.