Individual provider Active NPI

Jaclyn Cinquemani, M.A., BCBA

  • Behavior Analyst
  • East Islip, NY
National Provider Identifier
1124486485
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
001269-1 Issued in NY
Practice address
54 W Madison St
East Islip, NY 11730-1149
Phone
(631) 901-6778
NPI assigned
Feb 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 001269-1 NY Primary

Addresses

Primary practice location

54 W Madison St
East Islip, NY 11730-1149

Mailing address

54 W Madison St
East Islip, NY 11730-1149
Phone (631) 901-6778

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
001269-1NYMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1124486485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 W MADISON ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117301149",
            "telephone_number": "631-901-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 W MADISON ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117301149",
            "telephone_number": "631-901-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CINQUEMANI",
        "first_name": "JACLYN",
        "credential": "M.A., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "001269-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.