JYOTHI MAMMEN NP
NPI 1194298406
Nurse Practitioner - Family in Staten Island, NY
Active since January 09, 2019
About Jyothi Mammen Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JYOTHI MAMMEN NP (NPI 1194298406) is an individual family provider in Staten Island, New York, licensed in New York (343382) and active in the NPI registry since January 2019.
NPPES Registry Identity
NPI1194298406
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJYOTHI MAMMENCredential: NP
Location Address4143 RICHMOND AVE STE 1Staten Island, NY 10312-5637
Mailing Address682 Forest AveStaten Island, NY 10310-2507 · (718) 370-3730 · Fax (718) 698-9412
Phone(718) 966-5556
Sole ProprietorYes
Enumeration DateJanuary 9, 2019
✔ NPI 1194298406 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 343382
4143 RICHMOND AVE STE 1, Staten Island, NY 10312
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194298406, enumerated as an "individual" on January 09, 2019.
The provider is located at 4143 RICHMOND AVE STE 1 STATEN ISLAND, NY 10312 and the phone number is (718) 966-5556.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
