Basic Information
| Provider Information | |||||||||
| NPI: | 1548314149 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAQUIOT | ||||||||
| FirstName: | JACQUES | ||||||||
| MiddleName: | |||||||||
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| Credential: | NUTRITIONIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9338 SPRINGFIELD BLVD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | QUEENS VILLAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114281859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183633927 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 592 ROCKAWAY AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112125539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183455000 | ||||||||
| FaxNumber: | 7183466747 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133N00000X | Y | Dietary & Nutritional Service Providers | Nutritionist |
No ID Information.