Individual
JACLYN SUZANNE PORCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 PERRYRIDGE RD, GREENWICH, CT 06830-4608
(212) 746-2959
Mailing address
17 COUNTRY RIDGE DR, RYE BROOK, NY 10573-7043
(619) 929-7324
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
123873
CT
163W00000X
Registered Nurse
556384
NY
Other
Enumeration date
09/09/2013
Last updated
04/30/2015
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