| | Physician Last Name: | Jacobs |
| | Physician First Name: | Brad |
| | Physician Middle Name: | Justin |
| | Address: | 134 Foxwood Drive
Jericho, NY 11753 |
| | License Number: | 175524 |
| | License Type: | MD |
| | Year of Birth: |
1961
|
| | Effective Date: | 09/21/2007 |
| | Action Description for DOH Webpage: | License surrender. |
| | Misconduct Description for DOH Webpage: | The physician admits that he can not successfully defend against the charges of gross negligence; negligence and incompetence on more than one occasion; performing professional services not authorized by the patient; engaging in conduct which evidences moral unfitness and failing to maintain adequate records. Previously the physician's New York State medical license was summarily suspended effective June 18, 2007. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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