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General NPI Number Information
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NPI Number | 1790373504
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Entity Type | Organization
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Legal Business Name | JACLYN A. FARINO, NP IN ADULT HEALTH & PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 159 CARLETON AVE
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City | CENTRAL ISLIP
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State | NY
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Zip | 11722
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Country | US
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Telephone | 631-304-2711
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Fax |
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Provider Business Mailing Address
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Address Line | 92 BROADWAY STE 220
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City | GREENLAWN
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State | NY
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Zip | 11740-1328
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Country | US
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Telephone | 631-304-2711
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | JACLYN A FARINO
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Credential | NP
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Telephone | 631-304-2711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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