Jackito Jugan Daitol, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NN09365100 Issued in NJ

Practice address

385 Tremont Ave
East Orange, NJ 07018-1023

Phone

(973) 676-1000

Fax

(973) 395-7003

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jack Jugan Daitol Other name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1891762662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WALNUT ST",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072041350",
            "telephone_number": "908-245-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023",
            "telephone_number": "973-676-1000",
            "fax_number": "973-395-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAITOL",
        "first_name": "JACKITO",
        "middle_name": "JUGAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NN09365100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "DAITOL",
            "middle_name": "JUGAN",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patrick Owen Curtin, PHARM.D.
• Cycare
• Elizabeth Ann D'Andrea, PH.D.
• Olajumoke Adunola Dada
• Amro H Dafeella
• Daniel E Williams PHD PA
• Rupal S Dar, RPH
• Mohammed Dastghaib, MD
• Marlyn Dauway
• Latasha Davis-Hodges, LMFT

• Adult Health Nurse Practitioner in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.