Provider Demographics
NPI:1790183622
Name:PAULINE L. JACINTO MD
Entity type:Organization
Organization Name:PAULINE L. JACINTO MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUILNE
Authorized Official - Middle Name:LAGGUI
Authorized Official - Last Name:JACINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-283-3412
Mailing Address - Street 1:10 TEE LN
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-5157
Mailing Address - Country:US
Mailing Address - Phone:646-283-3412
Mailing Address - Fax:912-576-8686
Practice Address - Street 1:104 LAKESHORE DR STE B
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3809
Practice Address - Country:US
Practice Address - Phone:912-576-5249
Practice Address - Fax:912-576-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital