Individual
MS. KALA JESSY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1406 CECILY DR, MERRICK, NY 11566
(516) 205-3458
Mailing address
450 LAKEVILLE ROAD, ENTRANCE B, LAKE SUCCESS, NY 11042
(516) 734-8900
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F432665-01
NY
Other
Enumeration date
07/03/2023
Last updated
07/05/2023
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