Individual
DR. JACKLYN JOYCE NOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
25 N BELLMORE RD, #A, LEVITTOWN, NY 11756-1508
(516) 520-0274
(516) 520-1619
Mailing address
25 N BELLMORE RD, #A, LEVITTOWN, NY 11756-1508
(516) 520-0274
(516) 520-1619
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X005390-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01774198
—
NY
01
—
C05390-2
WORKERS COMPENSATION
NY
Enumeration date
10/21/2006
Last updated
07/09/2007
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