National Provider Identifier
Jacklyn Egan
Jacklyn Egan is listed in the NPPES registry with a primary specialty of Peer Specialist in Elmira, NY and a listed phone number of (607) 733-7661.
Profile Overview
- NPI
- 1093355851
- Provider Type
- Individual
- Primary Specialty
- Peer Specialist
- Enumeration Date
- January 09, 2020
- Last Updated
- January 09, 2020
Practice Location
- 1149 Sullivan St Ste B
- Elmira, NY 14901-1670
Phone: (607) 733-7661
Specialties
- Peer Specialist (175T00000X)
Full Record
- NPI
- 1093355851
- Entity Type
- Individual
- Last Name
- Egan
- First Name
- Jacklyn
- Mailing Street Address
- 1149 Sullivan St Ste B
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-1670
- Mailing Country
- US
- Practice Street Address
- 1149 Sullivan St Ste B
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14901-1670
- Practice Country
- US
- Practice Phone
- (607) 733-7661
- Enumeration Date
- January 09, 2020
- Last Updated
- January 09, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 09, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Peer Specialist (175T00000X)