Jackelyn Jaidda Alicea

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

356291 Issued in NY

Practice address

898 Connetquot Ave
Islip Terrace, NY 11752-1122

Phone

(631) 524-0110

NPI assigned

Sep 14, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1992616429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "898 CONNETQUOT AVE",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117521122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "898 CONNETQUOT AVE",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117521122",
            "telephone_number": "631-524-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEA",
        "first_name": "JACKELYN",
        "middle_name": "JAIDDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "356291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Islip Terrace, NY
• Providers in Islip Terrace, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.