Provider Demographics
NPI:1184027575
Name:SPIELMAN, JACQUELINE I
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:SPIELMAN
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HANLEY PL
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-3701
Mailing Address - Country:US
Mailing Address - Phone:631-844-2596
Mailing Address - Fax:212-510-5167
Practice Address - Street 1:7 HANLEY PLACE
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731
Practice Address - Country:US
Practice Address - Phone:631-844-2596
Practice Address - Fax:212-510-5167
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255606164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse