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
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | F335357 (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.