Individual
DR. JACQUELYN MCLEAN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
79 VANDENBURGH AVE, TROY, NY 12180-6024
(518) 271-0063
(518) 271-0298
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
212729
NY
Other
Enumeration date
07/31/2006
Last updated
02/01/2022
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