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Contact Information

MARYKUTTY JACOB, ANP-C
450 LAKEVILLE RD
SUITE M41
NEW HYDE PARK, NY11042-1117
 Phone: 516-734-8500
 Fax: 516-734-8537
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Health

363LA2200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MARYKUTTY JACOB · (Female)

NPI Number 1275836058
Status Active
Credentials ANP-C
Entity Individual
Enumeration date 12/16/2010
Last updated 12/16/2010 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • NY License # F 3055327-1
Hospital affiliation(s)
  • NORTH SHORE UNIVERSITY HOSPITAL - (Acute Care)
    300 COMMUNITY DRIVE
    MANHASSET, NY 11030
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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