Basic Information
| Provider Information | |||||||||
| NPI: | 1174875421 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JACOBSON | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | HOPE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 CROSS RIVER RD | ||||||||
| Address2: | |||||||||
| City: | KATONAH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147638151 | ||||||||
| FaxNumber: | 8888101176 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 CROSS RIVER RD | ||||||||
| Address2: | |||||||||
| City: | KATONAH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147638151 | ||||||||
| FaxNumber: | 8888101176 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 401530 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.