Jacob Thengampallil
Nurse Practitioner, Psych/Mental Health in Orangeburg, NY. Individual provider (NPI-1).
NPI number1447748843
StatusActive
Last updated in NPPESNov 3, 2020
Details
- NPI
- 1447748843
- Entity type
- Individual (NPI-1)
- Name
- Jacob Thengampallil
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 1, 2018
- Certification date
- Nov 3, 2020
- Last updated
- Nov 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 403172 | NY | Yes |
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | 592600 | NY |
Practice location
140 Old Orangeburg RdOrangeburg, NY 10962-1157
Phone 845-680-8694
Mailing address
140 Old Orangeburg RdOrangeburg, NY 10962-1157
Phone 845-680-8694
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All 9 Psychiatric/Mental Health Nurse Practitioner providers in Orangeburg · All 560 providers in Orangeburg
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