Provider Demographics
NPI:1023486941
Name:JACLYN HUNT
Entity type:Organization
Organization Name:JACLYN HUNT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MISS
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-730-4352
Mailing Address - Street 1:673 WOOLLEY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4217
Mailing Address - Country:US
Mailing Address - Phone:713-730-4352
Mailing Address - Fax:
Practice Address - Street 1:673 WOOLLEY AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4217
Practice Address - Country:US
Practice Address - Phone:713-730-4352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY814846706251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health