| Jacqueline Ponticiello Psychiatric Np, Pllc | |
|
1901 Vestal Pkwy E Ste 2w Vestal NY 13850-1966 | |
| (607) 341-4950 | |
| (607) 341-4933 |
| Full Name | Jacqueline Ponticiello Psychiatric Np, Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1901 Vestal Pkwy E Ste 2w, Vestal, New York |
| Authorized Official Name and Position | Jacqueline Ann Ponticiello (OWNER) |
| Authorized Official Contact | 6073414950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline Ponticiello Psychiatric Np, Pllc 1901 Vestal Pkwy E Ste 2w Vestal NY 13850-1966 Ph: (607) 341-4950 | Jacqueline Ponticiello Psychiatric Np, Pllc 1901 Vestal Pkwy E Ste 2w Vestal NY 13850-1966 Ph: (607) 341-4950 |
| NPI Number | 1487101226 |
|---|---|
| Provider Enumeration Date | 09/09/2016 |
| Last Update Date | 09/28/2024 |
| Certification Date | 09/28/2024 |
| Medicare PECOS PAC ID | 2567990567 |
|---|---|
| Medicare Enrollment ID | O20250103001495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487101226 | NPI | - | NPPES |
| Provider Name | Jacqueline Ponticiello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588977763 PECOS PAC ID: 9335320993 Enrollment ID: I20110302000422 |
| Provider Name | Brandon Michael Collings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013644152 PECOS PAC ID: 3971970765 Enrollment ID: I20250113001852 |
| Provider Name | Rachelle Del Rio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366129603 PECOS PAC ID: 6002344488 Enrollment ID: I20250113002831 |
| Provider Name | Kristina Singley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558029017 PECOS PAC ID: 2062804222 Enrollment ID: I20250114001356 |
| Provider Name | Michelle Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336612522 PECOS PAC ID: 7618380791 Enrollment ID: I20250114001931 |
| Provider Name | Janine Dewitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922774694 PECOS PAC ID: 2769873181 Enrollment ID: I20250115001105 |
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