National Provider Identifier Database

JACQUELINE PANDOLFI, NP – NPI #1225197866
Women's Health


Contact Information

JACQUELINE PANDOLFI, NP
12 MEDICAL DR
PORT JEFFERSON STATION, NY11776-1588
Phone: 631-331-4400
Fax: 631-331-3190
Website:
Specialty Taxonomy Code
* Women's Health 363LW0102X

* Indicates primary specialty

NPI Profile & details for JACQUELINE PANDOLFI

NPI Number 1225197866
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 12/08/2006
Last updated 01/14/2021 - About 5 years ago
Sole proprietor1 No
Identifiers
  • NY License #: 388956-1
  • NY Medicaid: 388956
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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