Individual
JAISON JACOB JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1600 OLD COUNTRY RD, PLAINVIEW, NY 11803-5013
(516) 433-3600
Mailing address
2401 S 31ST ST # MSAG407Q, TEMPLE, TX 76508-0001
(254) 724-9290
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10072178
TX
207RC0000X
Cardiovascular Disease Physician
Primary
342481
NY
390200000X
Student in an Organized Health Care Education/Training Program
BP10072178
TX
Other
Enumeration date
04/28/2020
Last updated
05/28/2026
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