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NPI Code Detail

MEDICARE: JACLYN MARIE PERAINO DO

MEDICARE: JACLYN MARIE PERAINO DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0402XNeurology with Special Qualifications in Child Neurology Physician05-51028KS
22084N0402XNeurology with Special Qualifications in Child Neurology Physician2022013734MO

General Provider Information

NPI Number : 1134756935
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACLYN MARIE PERAINO DO
Provider Business Mailing Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-234-3000
Fax Number :
Provider Business Practice Location Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-234-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2020
Last Update Date : 12/10/2025

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Directions to “ JACLYN MARIE PERAINO DO” Practice Location

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