Provider Demographics
NPI:1376987024
Name:PINCZEWSKI, JACQUELINE CASSANDRA (MS SPECIAL EDUCATION)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:CASSANDRA
Last Name:PINCZEWSKI
Suffix:
Gender:F
Credentials:MS SPECIAL EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 33RD ST
Mailing Address - Street 2:APT 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4875
Mailing Address - Country:US
Mailing Address - Phone:858-348-7386
Mailing Address - Fax:
Practice Address - Street 1:201 E 33RD ST
Practice Address - Street 2:APT 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4875
Practice Address - Country:US
Practice Address - Phone:858-348-7386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst