Jacqueline Vandemark
Individual provider Active NPI Case Management Agency · Cuddebackville, NY
NPI 1033838008 · NPPES record last updated Aug 24, 2022
Key facts
- NPI
- 1033838008
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Agency 251B00000X
- Practice address
- 1190 US Route 209
Cuddebackville, NY 12729-5321 - Phone
- (845) 321-4220
- NPI assigned
- Aug 24, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Yes |
Addresses
Primary practice location
1190 US Route 209
Cuddebackville, NY 12729-5321
Mailing address
1190 US Route 209
Cuddebackville, NY 12729-5321
Phone (845) 321-4220
Other providers in Cuddebackville, NY
All providers in Cuddebackville, NY · Case Management Agency in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.