Individual
TINU JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.P.
Contact information
Practice address
1300 BELMONT AVE, NEW HYDE PARK, NY 11040-4218
(516) 502-2887
Mailing address
1300 BELMONT AVE, NEW HYDE PARK, NY 11040-4218
(516) 502-2887
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
40401944
NY
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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