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

Jacklyn M Goncalves

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1396490538

Jacklyn M Goncalves is a Student in an Organized Health Care Education/Training Program in Massapequa, New York. Licensed in New York. Registered with an NPI since 2022.

Licensed in
NY
In the registry since
2022

Practice location Address checks out

70 Grand Ave
Massapequa, NY 11758-4906
Phone: (516) 799-3203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

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

Record details

NPI number1396490538
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 16, 2022
Last updated in NPPESFebruary 16, 2022
Certification dateFebruary 16, 2022
Mailing address70 16th St, Jericho, NY 11753-2419

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