Individual
MRS. JACQUELINE CONCEPCION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
410 LAKEVILLE RD STE 107, NEW HYDE PARK, NY 11042-1102
(516) 465-5400
Mailing address
62 TWIG LN, LEVITTOWN, NY 11756-1810
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F308226-1
NY
Other
Enumeration date
07/31/2017
Last updated
07/31/2017
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