Healthcare Provider Details

I. General information

NPI: 1386591519
Provider Name (Legal Business Name): JINSY RAJAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JINSY JACOB

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8208 LANGDALE ST
NEW HYDE PARK NY
11040-1821
US

IV. Provider business mailing address

8208 LANGDALE ST FL 2
NEW HYDE PARK NY
11040-1821
US

V. Phone/Fax

Practice location:
  • Phone: 516-582-4590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number689641
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: