Individual
JACQUELINE MINASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1991 MARCUS AVE SUITE 300, NEW HYDE PARK, NY 11042-2123
(516) 719-3376
(516) 321-8514
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
286880
NY
207N00000X
Dermatology Physician
T9451
TX
Other
Enumeration date
03/31/2012
Last updated
12/09/2022
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