DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: JACK ALBERT MCENROE

MEDICARE: JACK ALBERT MCENROE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1720733918
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACK ALBERT MCENROE
Provider Business Mailing Address
First Line : 70 N WOODHULL RD APT 1
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-2858
Country : US
Telephone Number : 516-330-9753
Fax Number :
Provider Business Practice Location Address
First Line : 173 WINDWATCH DR
Second Line :
City : HAUPPAUGE
State : NY
Zip : 11788-3353
Country : US
Telephone Number : 516-672-5771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2022
Last Update Date : 12/07/2025

Similar Medicare Providers

1407478621 — JULIA ROSE RUFFINO
Practice Location Address:
173 WINDWATCH DR
HAUPPAUGE, NY
11788-3353
Practice Phone: 516-672-5771
Practice Fax:
1669336939 — CATELYN BURKE
Practice Location Address:
173 WINDWATCH DR
HAUPPAUGE, NY
11788-3353
Practice Phone: 516-672-5771
Practice Fax:
1043173461 — SUMAYA KHANFRI
Practice Location Address:
173 WINDWATCH DR
HAUPPAUGE, NY
11788-3353
Practice Phone: 631-572-8967
Practice Fax:
1902769169 — ISABELLA PARASMO
Practice Location Address:
173 WINDWATCH DR
HAUPPAUGE, NY
11788-3353
Practice Phone: 631-572-8967
Practice Fax:
1457223422 — PATRICIA MCGLOIN
Practice Location Address:
173 WINDWATCH DR
HAUPPAUGE, NY
11788-3353
Practice Phone: 631-572-8967
Practice Fax:
1821967126 — BRITTANY SCHALLER
Practice Location Address:
173 WINDWATCH DR
HAUPPAUGE, NY
11788-3353
Practice Phone: 631-572-8967
Practice Fax:

Directions to “ JACK ALBERT MCENROE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.