Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jaclynn DO, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053014928

Dr. Jaclynn DO, MD is a Student in an Organized Health Care Education/Training Program in Bay Shore, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

301 E Main St
Bay Shore, NY 11706-8408
Phone: (631) 894-5943
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1300 Roanoke Ave, Riverhead, NY 11901-2031 — (631) 894-5943

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (NY)

Record details

NPI number1053014928
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2023
Last updated in NPPESMarch 22, 2023
Certification dateMarch 21, 2023

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