MS. ALICIA JACOB (NPI# 1700314820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700314820 |
| Entity Type | Individual |
| Full Name | MS. ALICIA JACOB |
| Credential | FNP |
| Practice Address |
660 Collfield Ave Staten Island NY 10314 |
| Practice Telephone | 3472060938 |
| Mailing Telephone | 3472060938 |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2017-06-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
341484 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
660 COLLFIELD AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871194027 | Wai Ying Chan | Nurse Practitioner | 659 Britton Ave, Staten Island, NY 10304-4463 | 2020-11-04 |
| 1215542923 | Margaret Chifong Tam | Nurse Practitioner | 85 Venice Avenue, Staten Island, NY 10304 | 2020-09-10 |
| 1215540638 | Shanna Hinckson | Nurse Practitioner | 53 Tillman St, Staten Island, NY 10314-5680 | 2020-08-25 |
| 1104438548 | Amanda Power | Nurse Practitioner | 64 Lovell Ave, Staten Island, NY 10314-4969 | 2020-08-18 |
| 1497367817 | Darya Olekhnovich | Nurse Practitioner | 25 Navesink Pl, Staten Island, NY 10306-5622 | 2020-08-18 |
| 1194335372 | Kimberly Sage | Nurse Practitioner | 36 Carly Ct, Staten Island, NY 10309-2735 | 2020-08-03 |
| 1932718855 | Christine Louise Lutrario | Nurse Practitioner | 293 Edinboro Rd, Staten Island, NY 10306-1204 | 2020-07-27 |
| 1447877592 | Mirena Khaimova | Nurse Practitioner | 302 Getz Ave, Staten Island, NY 10312-2433 | 2020-07-05 |
| 1063039220 | Hima Girish | Nurse Practitioner | 64 Galloway Ave, Staten Island, NY 10302-2528 | 2020-07-02 |
| 1245854314 | Desiree Joy Ambrosio | Nurse Practitioner | 45 Burnside Ave, Staten Island, NY 10302-2302 | 2020-06-03 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on MS. ALICIA JACOB.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.