James Jacob
Nurse Anesthetist, Certified Registered in Mineola, NY. Individual provider (NPI-1).
NPI number1164039855
StatusActive
Last updated in NPPESSep 26, 2020
Details
- NPI
- 1164039855
- Entity type
- Individual (NPI-1)
- Name
- James Jacob
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 26, 2020
- Certification date
- Sep 21, 2020
- Last updated
- Sep 26, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 632221 | NY | Yes |
Practice location
259 1st StMineola, NY 11501-3957
Phone 516-663-0333
Mailing address
10716 91st StOzone Park, NY 11417-1421
Phone 347-255-5086
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All 25 Certified Registered Nurse Anesthetist providers in Mineola · All 2,401 providers in Mineola
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