Individual
MRS. JACLYN LEE CARNEVALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 AMSTERDAM AVE, NEW YORK, NY 10023-7410
(516) 680-7538
Mailing address
600 NORTHERN BLVD SUITE #111, GREAT NECK, NY 11021
(516) 387-3990
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
018929
NY
Other
Enumeration date
08/18/2015
Last updated
01/20/2026
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