Jackelyn R Waldman, SPECIAL EDUCATOR

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

Family of Kidz
1400 Old Country Road
Westbury, NY 11590

Phone

(516) 806-6969

NPI assigned

Jan 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jackelyn R Glass Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1619638657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 NANCY BLVD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663119",
            "telephone_number": "516-359-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAMILY OF KIDZ",
            "address_2": "1400 OLD COUNTRY ROAD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "11590",
            "telephone_number": "516-806-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "JACKELYN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "SPECIAL EDUCATOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKELYN",
            "last_name": "GLASS",
            "middle_name": "R",
            "prefix": "MISS",
            "credential": "SPECIAL EDUCATOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacqueline Voulgaris
• Brittany Wade
• Judy Wagman, LICENSED CLINICAL SO
• Michael Wakily, DDS
• Wal-Mart Stores East LP
• Walgreen Co
• Walgreen Co
• Brenda Wallace-Levy, PA
• Bridget Quinn Wallace, TEACHER
• David Alan Walls, DDS

• Specialist in Westbury, NY
• Providers in Westbury, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.

Verify at the official NPI Registry.