Individual
MRS. JACQUELINE VANDEMARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1190 US ROUTE 209, CUDDEBACKVILLE, NY 12729-5321
(845) 321-4220
Mailing address
1190 US ROUTE 209, CUDDEBACKVILLE, NY 12729-5321
(845) 321-4220
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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