Individual provider · Type 1 NPI

Raimol Jacob, NP

Family Nurse Practitioner · Bronx, NY

NPI number 1720306350 Active

Practice location

2488 Grand Concourse, 4th Floor Room 424
Bronx, NY 10458-5203

Fax (516) 484-6084

Mailing address

61 Manorhaven Blvd
Port Washington, NY 11050-1627

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XF335357 (NY)

Family Nurse Practitioner: Definition to come...

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About NPI 1720306350

Raimol Jacob, NP's National Provider Identifier is 1720306350, issued on May 6, 2010. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Bronx, NY. The record was last updated on May 6, 2010.