Most Relevant Information
Provider Data
| NPI Number: | 1003673948 |
| Provider Name: | SUNITHA JACOB |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | F353417 |
Most Important Dates
| Enumeration Date: | 03/05/2024 |
| Last Updated: | 03/05/2024 |
Provider Practice Location
51-55 N ROUTE 9W
WEST HAVERSTRAW
NY
109931195
Practice Location Phone/Fax
| Phone: | 8457864000 |
| Fax: |
Provider Mailing Location
139 BLAUVELT RD
NANUET
NY
109543601
Provider Mailing Phone/Fax
| Phone: | 9144260159 |
| Fax: |