Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Daniel Canavan, MD

Individual provider Emergency Medicine Physician · NPI 1104402908

Jacob Daniel Canavan, MD is an Emergency Medicine Physician in Bronx, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1650 Grand Concourse
Bronx, NY 10457-7679
Phone: (718) 992-7669
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 250 W 57th St, New York, NY 10107-0001 — (212) 523-8158

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 327964 (NY)

Record details

NPI number1104402908
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2021
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024
Mailing address1650 Grand Concourse, Bronx, NY 10457-7679

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