| Doctor Name: | DR. STACY LYNN JACOBS |
| NPI Number: | 1801096078 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 225209 |
| Business Practice Address: | 233 E 69th St Apt 8b New York, NY - 100215414 |
| Business Phone Number: | 2125175406 |
| Business Fax Number: | 2125351564 |
| Mailing Address: | 233 E 69th St, Apt 8b NEW YORK |
| State: | NY |
| Postal Code: | 100215414 |
| Phone Number: | 2125175406 |
| Fax Number: | 2125351564 |
| NPI Enumeration Date: | 07/24/2007 |
| NPI Last Update Date: | 05/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 225209 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |