MEDICARE: CLEMENTE SAINT-JACQUES

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
1	163W00000X	Registered Nurse	788552-01	NY

General Provider Information

NPI Number	:	1982891321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLEMENTE SAINT-JACQUES

Provider Business Mailing Address
First Line	:	PO BOX 776
Second Line	:	PECK SLIP STATION
City	:	NEW YORK
State	:	NY
Zip	:	10272-0776
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1495 E 92ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-5007
Country	:	US
Telephone Number	:	917-204-6337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	05/04/2020

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Directions to “ CLEMENTE SAINT-JACQUES ” Practice Location

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