| Doctor Name: | ZACHARY COLIN JACOBS |
| NPI Number: | 1215179973 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 279031 |
| Business Practice Address: | 492 Montauk Hwy East Moriches, NY - 119401347 |
| Business Phone Number: | 6316382900 |
| Business Fax Number: | 6318788083 |
| Mailing Address: | Po Box 1559, STONY BROOK |
| State: | NY |
| Postal Code: | 117900989 |
| Phone Number: | 6314440650 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2009 |
| NPI Last Update Date: | 05/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | 279031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |