Keziah Elsa Jacob, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

068595 Issued in NY

Practice address

53-11 Roosevelt Ave
Queens, NY 11377

Phone

(718) 255-6355

NPI assigned

Dec 28, 2021

Sex

Female

Sole proprietor

No

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

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1922768290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 ROOSEVELT AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774238",
            "telephone_number": "516-233-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53-11 ROOSEVELT AVE",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11377",
            "telephone_number": "718-255-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "KEZIAH",
        "middle_name": "ELSA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "068595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faizal Hussein, DR.
• Lily Hwang
• Shreya Mukund Ingle, MD, MPH
• Yelena Iskhakova, PHARM.D
• Frannie Itzkow, BMBS
• Annamma James I
• Shaghayegh Javan
• Rafia Jawed, M.D.
• Samuel Jeannite, PSY.D
• Jenny Cheng Jin, MD

• Pharmacist in Queens, NY
• Providers in Queens, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.