Active NPI
Jaclyn Danielle Leet, RDN
- Registered Dietitian
- Bloomingdale, NJ
National Provider Identifier
1013462993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86083824
- Practice address
- 42 Chestnut St
Bloomingdale, NJ 07403-1729 - Phone
- (973) 919-7330
- NPI assigned
- Aug 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86083824 | NJ | Primary |
Addresses
Primary practice location
42 Chestnut St
Bloomingdale, NJ 07403-1729
Mailing address
5 Brotherton Ave
Rockaway, NJ 07866-4801
Phone (973) 919-7330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86083824 | NJ | MD | Registered Dietitian |
Networks
- devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
- IL HMO C-SNP
- TX HMO
- IL PPO Downstate
- TX HMO D-SNP
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1013462993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 BROTHERTON AVE",
"city": "ROCKAWAY",
"state": "NJ",
"postal_code": "078664801",
"telephone_number": "973-919-7330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 CHESTNUT ST",
"city": "BLOOMINGDALE",
"state": "NJ",
"postal_code": "074031729",
"telephone_number": "973-919-7330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEET",
"first_name": "JACLYN",
"middle_name": "DANIELLE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-19",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NJ",
"license": "86083824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.