Gloria Jackson

NPI 1013352079 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1013352079
Enumeration Date 05/05/2013
Last Updated 05/05/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name GLORIA GLORIA
Position LPN
Phone (631) 226-3901
Fax
Practice Location
525 S 9TH ST
LINDENHURST NY, 11757-4529, US
Phone (631) 226-3901
Fax
Business Location
525 S 9TH ST
LINDENHURST NY, 11757-4529, US
Phone (631) 226-3901
Fax
Toxanomy
Taxonomy Code 314000000X
License State New York
License Number 252415-1
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According to our database, Gloria Jackson NPI is 1013352079, taxonomy code is 314000000X and license number is 252415-1, license state is located at New York. Gloria Jackson physically located at 525 S 9th St, Lindenhurst NY, 11757-4529. NPI Number 1033115704 has the healthcare provider type.

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1013352079 NPI number is provided on an as is basis without warranty of any kind. 1013352079 is maintained by the National Plan & Provider Enumeration System. The contents of Gloria Jackson are for informational purposes only.