Provider Demographics
NPI:1740794064
Name:BACHMAN, JACQUELINE TAYLOR (MSED)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:TAYLOR
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 W 34TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2354
Mailing Address - Country:US
Mailing Address - Phone:212-420-0510
Mailing Address - Fax:
Practice Address - Street 1:460 W 34TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2354
Practice Address - Country:US
Practice Address - Phone:212-420-0510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist