Individual
JESSY THOTTANKARAMALIL JOSHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
(718) 264-4050
Mailing address
8159 248TH ST, BELLEROSE, NY 11426-1718
(347) 551-8335
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
469726
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50150
—
NY
Enumeration date
02/09/2018
Last updated
02/09/2018
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