| Doctor Name: | JOHN ANTHONY JACKALONE |
| NPI Number: | 1174620983 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | N005711 |
| Business Practice Address: | 4295 Hempstead Tpke Bethpage, NY - 117145713 |
| Business Phone Number: | 5165793500 |
| Business Fax Number: | 5165793802 |
| Mailing Address: | Po Box 118, BETHPAGE |
| State: | NY |
| Postal Code: | 117140118 |
| Phone Number: | 5165793500 |
| Fax Number: | 5165793802 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 04/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | N005711 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |