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MELISSA JACOB NP
NPI 1396661922
Nurse Practitioner - Family in Queens Village, NY

Active since June 27, 2026
21717 103RD AVE, QUEENS VILLAGE, NY 11429(917) 613-4074 Get Directions Write a Review

NPPES record last updated: June 27, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Melissa Jacob Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELISSA JACOB NP (NPI 1396661922) is an individual family provider in Queens Village, New York, licensed in New York (354704) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1396661922
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMELISSA JACOBCredential: NP
Location Address21717 103RD AVEQueens Village, NY 11429-1116
Mailing Address21717 103rd AveQueens Village, NY 11429-1116 · (917) 613-4074
Phone(917) 613-4074
Sole ProprietorNo
Enumeration DateJune 27, 2026
NPPES CertifiedJune 27, 2026
✔ NPI 1396661922 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 · 354704
21717 103RD AVE, Queens Village, NY 11429
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Melissa Jacob's NPI number?

The NPI number for Melissa Jacob is 1396661922. It was assigned to this individual provider in the NPPES registry on June 27, 2026.

Where is Melissa Jacob located?

Melissa Jacob practices at 21717 103rd Ave, Queens Village, NY 11429. The listed phone number is (917) 613-4074.

What is Melissa Jacob's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Melissa Jacob was last updated on June 27, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.