Individual
JACKIE LYNN SPAGNUOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
116 LAMBERTS LN, STATEN ISLAND, NY 10314-7210
(718) 619-5867
Mailing address
50 LYNBROOK AVE, STATEN ISLAND, NY 10309-4509
(718) 619-5867
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F31110201
NY
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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