Individual
JACLYN O'DONOHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 FERN ST, FLORAL PARK, NY 11001-3207
(516) 852-5134
Mailing address
15 FERN ST, FLORAL PARK, NY 11001-3207
(516) 852-5134
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
312197
NY
Other
Enumeration date
10/24/2025
Last updated
10/24/2025
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