MISS STACY JACOB
Physician Assistant
Active
Individual
NPI: 1104333178
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | No | 329541-1 (NY) |
| Physician Assistant | 363A00000X | No | - |
Frequently Asked Questions
NPI 1104333178 is the National Provider Identifier for MISS STACY JACOB, a Physician Assistant provider located in Staten Island, NY. This NPI was enumerated on December 29, 2017.
MISS STACY JACOB practices at 475 SEAVIEW AVE, Staten Island, NY 10305.
Quick Facts
- NPI
- 1104333178
- Type
- Individual
- Enumerated
- Dec 29, 2017
- Last Updated
- Feb 2, 2026
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