Jacqueline Elizabeth Carballo | Spring Valley, NY • PECOS Search

Jacqueline Elizabeth Carballo

Registered Nurse

Nursing Service Providers

5 N Hillside Ave, Spring Valley, NY 10977-2331

PECOS Enrollment

Based on the most recent information from CMS, provider Jacqueline Elizabeth Carballo does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:54 AM.

Profile Details

Provider ID
1932535721
Provider Type
Individual
Full Name
Carballo, Jacqueline Elizabeth
Credential
R.N.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
9/24/2013
Last Updated
9/24/2013

Contact Information

Practice Location

5 N Hillside Ave, Spring Valley, NY 10977-2331

Unlisted Fax

Mailing Location

5 N Hillside Ave, Spring Valley, NY 10977-2331

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 163W00000X Primary	Description Registered Nurse Nursing Service Providers	License 674021 New York