Individual
RITA JAQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
5 CUBA HILL RD, GREENLAWN, NY 11740-1624
(631) 628-5000
Mailing address
146 DEER LAKE DR, NORTH BABYLON, NY 11703-3420
(631) 628-5000
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
803381
NY
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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