Individual
JACLYN MAE CHOTOWICKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(516) 661-1721
Mailing address
PO BOX 3501, NEW HYDE PARK, NY 11040-7501
(516) 661-1721
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
432092
NY
Other
Enumeration date
08/10/2021
Last updated
09/09/2021
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