Active NPI
Jennifer Hackett, B.A.
- Specialist
- Bohemia, NY
National Provider Identifier
1235586090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3532016
- Practice address
- 45 Crossway E
Bohemia, NY 11716-1204 - Phone
- (631) 218-4949
- NPI assigned
- May 20, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 3532016 | NY | Primary |
Addresses
Primary practice location
45 Crossway E
Bohemia, NY 11716-1204
Mailing address
117 Lincoln Ave
Holbrook, NY 11741-2259
Phone (631) 418-7755
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
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3532016 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1235586090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 LINCOLN AVE",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117412259",
"telephone_number": "631-418-7755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 CROSSWAY E",
"city": "BOHEMIA",
"state": "NY",
"postal_code": "117161204",
"telephone_number": "631-218-4949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKETT",
"first_name": "JENNIFER",
"name_prefix": "Miss",
"credential": "B.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-20",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "3532016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bohemia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.