Individual provider · Type 1 NPI
Jaclyn Lasita, RN, PNP
Pediatric Nurse Practitioner · Blue Point, NY
NPI number
1235790577
Active
Practice location
263 Blue Point Ave
Blue Point, NY 11715-1224
Mailing address
63 Tarpon Rd
Rocky Point, NY 11778-9579
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 745257 (NY) |
| Pediatric Registered Nurse | 163WP0200X | 745257 (NY) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | F383584 (NY) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1235790577
Jaclyn Lasita, RN, PNP's National Provider Identifier is 1235790577, issued on Jun 26, 2019. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Blue Point, NY. The record was last updated on Aug 21, 2023.