Individual ProviderJacqueline BennettRegistered NurseNursing Service ProvidersPractice Address2944 Tiemann Ave, Bronx, NY 10469-3322(646) 522-6871PECOS EnrollmentBased on the most recent information from CMS, provider Jacqueline Bennett does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1720492085Provider TypeIndividualFull NameBennett, JacquelineTitleMs.GenderFemaleSole ProprietorYesEnumeration Date6/16/2014Last Updated4/7/2015Contact InformationPractice LocationPractice Address2944 Tiemann Ave, Bronx, NY 10469-3322Phone(646) 522-6871FaxUnlisted FaxMailing LocationMailing Address2944 Tiemann Ave, Bronx, NY 10469-3322Phone(646) 522-6871FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense6715041New York