Samuel S Jacob, DO
Physical Medicine & Rehabilitation, Sports Medicine in Ridgewood, New Jersey
1134651391- Practice location
- 1200 East Ridgewood Avenue, East Wing, Suite 306,, Ridgewood, NJ 07450
- Phone
- 201-612-4857
- Fax
- —
- Last updated
- August 18, 2022
Samuel Sunny Jacob is a Physical Medicine & Rehabilitation, Sports Medicine based in Ridgewood, NJ. Samuel Sunny Jacob practices in Ridgewood, NJ and has the professional credentials of DO. The NPI Number for Samuel Sunny Jacob is 1134651391 and holds a License No. 25MB11490200 (NJ). The current practice location address for Samuel Sunny Jacob is 1200 East Ridgewood Avenue, East Wing, Suite 306,, Ridgewood, NJ 07450 and can be reached out via phone at 201-612-4857.
Provider Profile Details
- NPI Number
- 1134651391
- Provider Name
- Samuel Sunny Jacob
- Credential
- DO
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 1200 East Ridgewood Avenue, East Wing, Suite 306,, Ridgewood, NJ 07450
- Phone Number
- 201-612-4857
- Primary Taxonomy
- Physical Medicine & Rehabilitation, Sports Medicine · 2081S0010X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 28, 2017
- Last Update Date
- August 18, 2022
- Certification Date
- August 18, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1200 East Ridgewood Avenue
East Wing, Suite 306,
Ridgewood, NJ 07450 - City
- Ridgewood
- State
- New Jersey
- Zip
- 07450
- Phone Number
- 201-612-4857
Provider Business Mailing Address Details
- Address
- 18 Martino Way
Pomona, NY 10970-2649 - City
- Pomona
- State
- NY
- Zip
- 10970-2649
- Phone Number
- 914-318-0088
License Information
- License Number
- 25MB11490200
- License State
- NJ
- Taxonomy
- Physical Medicine & Rehabilitation, Sports Medicine · 2081S0010X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Samuel S Jacob, DO?
The NPI number of Samuel S Jacob, DO is 1134651391. It was assigned on March 28, 2017 and is currently active in the NPPES registry.
What is the specialty of Samuel S Jacob, DO?
Samuel S Jacob, DO is registered under the primary taxonomy Physical Medicine & Rehabilitation, Sports Medicine (code 2081S0010X), licensed in NJ under license number 25MB11490200.
Where does Samuel S Jacob, DO practice?
The practice location is 1200 East Ridgewood Avenue, East Wing, Suite 306,, Ridgewood, NJ 07450. The office can be reached at 201-612-4857 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1134651391 directly on the NPPES registry website.