Individual
JELETTA JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1090 AMSTERDAM AVE, NEW YORK, NY 10025-1737
(212) 523-5089
Mailing address
1090 AMSTERDAM AVE, NEW YORK, NY 10025-1737
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
Primary
311728-01
NY
2084P0800X
Psychiatry Physician
311728-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2017
Last updated
05/18/2022
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