Individual provider · Type 1 NPI

Jaclyn Marie Bonventre

Specialist · Center Moriches, NY

NPI number 1114361219 Active

Practice location

18 Cynthia Ln
Center Moriches, NY 11934-2602

Call (631) 909-2065 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X484461041 (NY)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1114361219

Jaclyn Marie Bonventre's National Provider Identifier is 1114361219, issued on Apr 20, 2013. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Center Moriches, NY. The record was last updated on Sep 5, 2013.