Raimol Jacob, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F335357 Issued in NY

Practice address

2488 Grand Concourse
4TH Floor Room 424
Bronx, NY 10458-5203

Phone

(212) 695-5122

Fax

(516) 484-6084

NPI assigned

May 6, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1720306350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MANORHAVEN BLVD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501627",
            "telephone_number": "516-883-7100",
            "fax_number": "516-883-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 GRAND CONCOURSE",
            "address_2": "4TH FLOOR ROOM 424",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585203",
            "telephone_number": "212-695-5122",
            "fax_number": "516-484-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "RAIMOL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Jaffe,Ed.D. Psychologist PC
• Dianna Elizabeth Jacob, RPA-C
• Jemi Jacob
• Jesslene Jacob
• Justin G Jacob
• Sherin Jacob, PHARMD, BCPS
• Subi Jacob
• Teena Jacob
• Viju Jacob
• Jacobi Medical Center

• Family Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.