Provider Demographics
NPI:1992934350
Name:JACOBS, LLOYDINE J (MD)
Entity type:Individual
Prefix:DR
First Name:LLOYDINE
Middle Name:J
Last Name:JACOBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:623 LAFAYETTE AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-2439
Mailing Address - Country:US
Mailing Address - Phone:844-724-6735
Mailing Address - Fax:855-723-2174
Practice Address - Street 1:229 MAIN ST UNIT 1100D
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-8823
Practice Address - Country:US
Practice Address - Phone:844-724-6735
Practice Address - Fax:855-723-2174
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT194697207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery