Individual
MS. JACQUELINE PANDOLFI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
12 MEDICAL DR, PORT JEFFERSON STATION, NY 11776-1588
(631) 331-4400
(631) 331-3190
Mailing address
900 MERCHANTS CONCOURSE STE 216, WESTBURY, NY 11590-5114
(516) 226-8373
(844) 632-8265
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
388956-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
388956
—
NY
Enumeration date
12/08/2006
Last updated
01/14/2021
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