Provider Demographics
NPI:1437424025
Name:JOCSON, JAIZELYN
Entity Type:Individual
Prefix:
First Name:JAIZELYN
Middle Name:
Last Name:JOCSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13508 91ST AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2803
Mailing Address - Country:US
Mailing Address - Phone:917-858-3985
Mailing Address - Fax:
Practice Address - Street 1:13508 91ST AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2803
Practice Address - Country:US
Practice Address - Phone:917-858-3985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303166164W00000X
NY694098163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse