Healthcare Provider Details

I. General information

NPI: 1982959623
Provider Name (Legal Business Name): MARTHING JACQUET NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CLARKSON AVE
BROOKLYN NY
11203-2054
US

IV. Provider business mailing address

2121 WASTBURY CT APT 5H
BROOKLYN NY
11225
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF312507-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: