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

Jacqueline Rae Kreckel

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1205456993

Jacqueline Rae Kreckel is a Student in an Organized Health Care Education/Training Program in Farmingdale, New York. Licensed in New York. Registered with an NPI since 2020.

Licensed in
NY
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

375 Fulton St
Farmingdale, NY 11735-3454
Phone: (718) 250-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 062044 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1205456993
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 22, 2020
Last updated in NPPESSeptember 24, 2021
Certification dateSeptember 24, 2021

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