Jacqueline Rose Thaw
NPI #1063396661 in West Islip, New York
Provider Information
- NPI Number
- 1063396661
- Entity Type
- Individual
- Name
- Jacqueline Rose Thaw
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Aug 5, 2025
- Last Updated
- Aug 5, 2025
Practice Location
- Address
- 1000 MONTAUK HWY
- City
- West Islip
- State
- New York
- ZIP Code
- 11795-4927
- Phone
- (631) 376-3000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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