Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. JACQUELINE E MARTIN, MS, RD, CDN
Active Sole ProprietorPediatric Nutrition · MASSAPEQUA PARK, NY
Registration Details
- NPI Number
- 1114208089
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 6, 2011 (14.635600461074 yrs)
- Last Updated
- Sep 6, 2011
- License
-
006357 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
13 AVENUE LOUISEMASSAPEQUA PARK, NY, 117623207Browse NY providers · Browse ZIP 11762
- Phone
- 5162363984
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.