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

Jeremy Jacob

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1174413934

Jeremy Jacob is a Student in an Organized Health Care Education/Training Program in Syosset, New York. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

6851 Jericho Tpke Ste 125
Syosset, NY 11791-4454
Phone: (516) 780-0111
Fax: (516) 441-1099
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1174413934
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 3, 2025
Last updated in NPPESJuly 3, 2025
Certification dateJuly 3, 2025
Mailing address21 Wallace Dr, Plainview, NY 11803-2926

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