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General NPI Number Information
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NPI Number | 1205505641
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Entity Type | Individual
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Provider Name | JAQUELYN ANGELINA PHARMAKIDES
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Gender | Female
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 148 MADISON AVE FL 6
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City | NEW YORK
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State | NY
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Zip | 10016-6700
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Country | US
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Telephone | 917-997-4849
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Fax |
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Provider Business Mailing Address
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Address Line | 300 SOMERSET ST APT 435
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City | HARRISON
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State | NJ
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Zip | 07029-2348
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Country | US
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Telephone | 914-536-7743
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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