IndividualActive
Jaisa Pallickal, MSN ANP
NPI 1003254657 · Adult Health Clinical Nurse Specialist · New York, NY
Provider details
- NPI number
- 1003254657
- Entity type
- Individual
- Primary specialty
- Adult Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- MSN ANP
- Sex
- Female
- Sole proprietor
- No
- License
- 305563 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
75 Broad St
0815
New York, NY 10004-2415
Phone: (718) 391-0611
Street-level locationGet directions
Mailing address
17 Best St
Westwood, NJ 07675-2701
Registry dates
- Enumerated
- 2013-06-05
- Last updated
- 2013-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.