Most Relevant Information
Provider Data
| NPI Number: | 1003177882 |
| Provider Name: | LORI DIAMOND JACOBS M.S.ED |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 509850041 |
Most Important Dates
| Enumeration Date: | 06/07/2012 |
| Last Updated: | 06/07/2012 |
Provider Practice Location
420 95TH ST
BROOKLYN
NY
112097404
Practice Location Phone/Fax
| Phone: | 7186809751 |
| Fax: |
Provider Mailing Location
2229 KNAPP ST
5A
BROOKLYN
NY
112295766
Provider Mailing Phone/Fax
| Phone: | 7183829810 |
| Fax: |