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NPI Code Detail

MEDICARE: MS. ELIZABETH JOMY JOSE DO

MEDICARE: MS. ELIZABETH JOMY JOSE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1114860616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH JOMY JOSE DO
Provider Business Mailing Address
First Line : 1 HEALTHY WAY
Second Line :
City : OCEANSIDE
State : NY
Zip : 11572-1551
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 HEALTHY WAY
Second Line :
City : OCEANSIDE
State : NY
Zip : 11572-1551
Country : US
Telephone Number : 516-632-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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