Individual
ELIZABETH JAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MALTESE DR, MIDDLETOWN, NY 10940-2115
(845) 342-4774
Mailing address
111 MALTESE DR, MIDDLETOWN, NY 10940-2141
(845) 342-4774
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F344238-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
344238
LICENSE
NY
Enumeration date
08/06/2019
Last updated
08/07/2019
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