Vanessa Jackson

NPI 1003204678 - Custodial Care Facility - 311ZA0620X

NPI Details
NPI 1003204678
Gender Female
Enumeration Date 01/05/2015
Last Updated 01/05/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
2922 FALCON AVE
FAR ROCKAWAY NY, 11691-1845, US
Phone (347) 576-9654
Fax
Business Location
2922 FALCON AVE
FAR ROCKAWAY NY, 11691-1845, US
Phone (347) 576-9654
Fax
Toxanomy
Taxonomy Code 311ZA0620X
License State New York
License Number 320584
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According to our database, Vanessa Jackson NPI is 1003204678, taxonomy code is 311ZA0620X and license number is 320584, license state is located at New York. Vanessa Jackson physically located at 2922 Falcon Ave, Far Rockaway NY, 11691-1845. NPI Number Vanessa Jackson has the Individual type.

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1003204678 NPI number is provided on an as is basis without warranty of any kind. 1003204678 is maintained by the National Plan & Provider Enumeration System. The contents of Vanessa Jackson are for informational purposes only.