Individual provider · Type 1 NPI
Jacqueline Videtto, PA-C
Medical Physician Assistant · Massapequa, NY
NPI number
1083049480
Active
Practice location
100 Veterans Blvd Ste 1
Massapequa, NY 11758-4945
Fax (516) 882-9605
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 016854 (NY) |
Medical Physician Assistant: Definition to come...
2 other providers at this address
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About NPI 1083049480
Jacqueline Videtto, PA-C's National Provider Identifier is 1083049480, issued on Sep 5, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Massapequa, NY. The record was last updated on Sep 30, 2025.