Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jisha Jacob

Individual provider Family Medicine Physician · NPI 1437957701

Jisha Jacob is a Family Medicine Physician in Passaic, New Jersey. Licensed in Illinois, New Jersey and New York. Registered with an NPI since 2025.

Licensed in
IL, NJ, NY
In the registry since
2025
Specialties on file
3

Practice location Address checks out

615 Main Ave # 7055
Passaic, NJ 07055-5066
Phone: (800) 200-8196
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 26NJ15521400 (NJ)
Family Medicine Physician Taxonomy 207Q00000X · Licence 357923 (NY)
Family Medicine Physician Taxonomy 207Q00000X · Licence 209030880 (IL)

Record details

NPI number1437957701
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 4, 2025
Last updated in NPPESJuly 9, 2026
Certification dateJuly 9, 2026
Mailing address47 Old Middletown Rd, Nanuet, NY 10954-3208

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