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NPI Code Detail

MEDICARE: JESSICA BLAIN RN

MEDICARE: JESSICA BLAIN RN
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
1163W00000XRegistered Nurse903498NY

General Provider Information

NPI Number : 1437092293
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BLAIN RN
Provider Business Mailing Address
First Line : 580 WHITE PLAINS RD STE 510
Second Line :
City : TARRYTOWN
State : NY
Zip : 10591-5152
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 580 WHITE PLAINS RD STE 510
Second Line :
City : TARRYTOWN
State : NY
Zip : 10591-5152
Country : US
Telephone Number : 914-345-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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