Most Relevant Information
Provider Data
| NPI Number: | 1003054032 |
| Provider Name: | JACQUELINE MADDIE R.N. |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 415108 |
Most Important Dates
| Enumeration Date: | 01/29/2009 |
| Last Updated: | 01/29/2009 |
Provider Practice Location
22 AVENUE I
FARMINGDALE
NY
117351610
Practice Location Phone/Fax
| Phone: | 6317560225 |
| Fax: |
Provider Mailing Location
22 AVENUE I
FARMINGDALE
NY
117351610
Provider Mailing Phone/Fax
| Phone: | 6317560225 |
| Fax: |