MR. RAYMOND PATRICK JACOB (NPI# 1255515409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255515409 |
| Entity Type | Individual |
| Full Name | MR. RAYMOND PATRICK JACOB |
| Credential | C.O.T.A. |
| Practice Address |
24 Ferguson Ave Port Jervis NY 12771-1605 |
| Mailing Address |
24 Ferguson Ave. Port Jervis NY 12771-1605 |
| Practice Telephone | 9144437973 |
| Mailing Telephone | 9144437973 |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2007-12-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | 002794 | NY | Other Service Providers |
| N | 246ZA2600X |
Specialist/Technologist, Other Specialization: Art, Medical |
002794 | NY | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
24 FERGUSON AVE |
| City | PORT JERVIS |
| State | NY |
| Zip Code | 12771-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164045571 | Mary Ann Ricci | Counselor | 155 West Main, Port Jervis, NY 12771 | 2020-05-20 |
| 1982236022 | Jylian Ann Jackson | Social Worker | 146 Pike Street Outpatient Clinic, Port Jervis, NY 12771 | 2020-02-06 |
| 1336605591 | Dominic James Costantino | Physical Therapist | 17 Franklin Street, Port Jervis, NY 12771 | 2019-02-13 |
| 1871011775 | Pamela Ann Gluck | Counselor | 17 Sussex Street, Port Jervis, NY 12771 | 2017-08-31 |
| 1891211868 | Jamie Muller | Home Health Aide | 12 Mt William St, Port Jervis, NY 12771 | 2017-08-21 |
| 1922456649 | Greenville Township Volunteer Ambulance Corps Inc | Ambulance | 1495 Greenville Turnpike, Port Jervis, NY 12771 | 2016-06-03 |
| 1659702363 | Agnes Timberger | Social Worker | 626 Eatontown Road, Port Jervis, NY 12771 | 2013-12-05 |
| 1962795708 | Olga I Murray | Registered Nurse | 125 E. Main St., Port Jervis, NY 12771 | 2011-05-26 |
| 1407089444 | Daniel David Gersten | Counselor | 17-19 Sussex Street, Port Jervis, NY 12771 | 2009-08-25 |
| 1447404736 | Ann Marie Brown | Counselor | 136 Jersey Avenue, Suite 1, Port Jervis, NY 12771 | 2008-11-13 |
| Find all providers in zip 12771 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538445655 | Miguelina A Cabrera | Contractor | 571 Mountain Rd, Port Jervis, NY 12771-3165 | 2011-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022455 | Michael Charles Findlay | Contractor | 9509 32nd Ave Fl 1, East Elmhurst, NY 11369-1849 | 2020-10-27 |
| 1659971869 | Stephanie Rosario | Contractor | 1184 Evergreen Ave Apt 6d, Bronx, NY 10472-3235 | 2020-10-27 |
| 1306443791 | Julie Ann Hall | Contractor | 2326 Valley View Dr, Allegany, NY 14706-9669 | 2020-10-08 |
| 1104431618 | Elizabeth Anne Oakes-lani | Contractor | 5 Motts Ln, Glenwood Landing, NY 11547-3015 | 2020-09-11 |
| 1295357598 | Scale Rcm | Contractor | 251 Mountainview Ave Ste 7, Nyack, NY 10960-1700 | 2020-05-11 |
| 1972124758 | Christopher Boston | Contractor | 24917 148th Rd, Rosedale, NY 11422-2711 | 2020-05-03 |
| 1700407004 | Ethel M Webb | Contractor | 495 Attridge Road, 2, Churchville, NY 14428-1462 | 2020-04-28 |
| 1063046845 | Valerie Kaufman | Contractor | 3611 Henry Hudson Pkwy Apt 5b, Bronx, NY 10463-1554 | 2020-03-02 |
| 1033742671 | Rochester Flooring Kitchen & Bath Inc. | Contractor | 360 Jefferson Rd, Rochester, NY 14623-2644 | 2020-02-21 |
| 1881239317 | Whitney L Coventry | Contractor | 26 Greenwood Dr, Orchard Park, NY 14127-3913 | 2019-11-07 |
| Find all providers with the same taxonomy | ||||
| City | PORT JERVIS |
| Zip Code | 12771 |
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| 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.