National Provider Identifier

Marc Jacobson, PA

Marc Jacobson, PA is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Canandaigua, NY and a listed phone number of (585) 394-1960.

NPI 1588329452Canandaigua, NYSurgical Physician Assistant

Profile Overview

NPI
1588329452
Provider Type
Individual
Primary Specialty
Surgical Physician Assistant
Enumeration Date
November 04, 2021
Last Updated
March 11, 2022

Practice Location

  • 229 Parrish St Ste 100
  • Canandaigua, NY 14424-1791

Phone: (585) 394-1960

Mailing Address

  • 100 Kings Hwy S
  • Rochester, NY 14617-5504

Specialties

  • Surgical Physician Assistant (363AS0400X)
Full Record
NPI
1588329452
Entity Type
Individual
Last Name
Jacobson
First Name
Marc
Credential
PA
Mailing Street Address
100 Kings Hwy S
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14617-5504
Mailing Country
US
Mailing Phone
(585) 394-1960
Mailing Fax
(585) 393-9232
Practice Street Address
229 Parrish St Ste 100
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-1791
Practice Country
US
Practice Phone
(585) 394-1960
Practice Fax
(585) 393-9232
Enumeration Date
November 04, 2021
Last Updated
March 11, 2022
Sex
Male
Sole Proprietor
No
Certification Date
March 11, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Surgical Physician Assistant (363AS0400X)