Individual
PAUL T JAECKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RDN
Contact information
Practice address
431 62ND ST UNIT 305, WEST NEW YORK, NJ 07093-2326
(631) 942-0473
Mailing address
431 62ND ST UNIT 305, WEST NEW YORK, NJ 07093-2326
(631) 942-0473
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86299925
NY
Other
Enumeration date
12/19/2023
Last updated
07/22/2024
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