Provider Demographics
NPI:1992821169
Name:JABLOW, JOAN B (MS, APRN, NP)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:B
Last Name:JABLOW
Suffix:
Gender:F
Credentials:MS, APRN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 BYRAM LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3419
Mailing Address - Country:US
Mailing Address - Phone:914-244-1084
Mailing Address - Fax:914-241-1246
Practice Address - Street 1:45 BYRAM LAKE RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3419
Practice Address - Country:US
Practice Address - Phone:914-244-1084
Practice Address - Fax:914-241-1246
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400381363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health