Jenny Jackson RPA-C

NPI 1386767440 - Physician Assistant - 363A00000X

NPI Details
NPI 1386767440
Gender Female
Enumeration Date 04/06/2007
Last Updated 11/02/2015
Entity Type Individual
Active Over 9 years ago
Practice Location
200 OLD COUNTRY RD
SUITE 120
MINEOLA NY, 11501-4235, US
Phone (516) 663-1223
Fax (516) 663-1221
Business Location
200 OLD COUNTRY RD
SUITE 120
MINEOLA NY, 11501-4235, US
Phone (516) 663-1223
Fax (516) 535-6726
Toxanomy
Taxonomy Code 363A00000X
License State New York
License Number 011580
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According to our database, Mrs. Jenny Jackson RPA-C NPI is 1386767440, taxonomy code is 363A00000X and license number is 011580, license state is located at New York. Jenny Jackson RPA-C physically located at 200 Old Country Rd, Mineola NY, 11501-4235. NPI Number Jenny Jackson RPA-C has the Individual type.

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1386767440 NPI number is provided on an as is basis without warranty of any kind. 1386767440 is maintained by the National Plan & Provider Enumeration System. The contents of Jenny Jackson RPA-C are for informational purposes only.