National Provider Identifier Database

JACLYN R CUCCINELLO, NP – NPI #1043476237
Women's Health


Contact Information

JACLYN R CUCCINELLO, NP
5225 RTE 347 STE 70
PORT JEFFERSON STATION, NY11776-2061
Phone: 631-331-8777
Fax: 631-474-9169
Website:
Specialty Taxonomy Code
* Women's Health 363LW0102X
Registered Nurse 163W00000X

* Indicates primary specialty

NPI Profile & details for JACLYN R CUCCINELLO

NPI Number 1043476237
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 08/06/2008
Last updated 07/11/2019 - About 7 years ago
Sole proprietor1 No
Identifiers
  • NY License #: 565107
  • NY License #: F421258-1
  • NY Medicaid: 565107
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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