MISS STACY JACOB

Physician Assistant

Active Individual
NPI: 1104333178

Practice Address

475 SEAVIEW AVE
Staten Island, NY 10305

Phone: (718) 266-9000

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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