DAVID IRA JACKSON

PATCHOGUE, NY
NPI1013950302
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  005486)
Enumeration Date2006-06-14
Last Update Date2007-07-08
Business Address
-- DAVID IRA JACKSON PA
101 HOSPITAL ROAD MEDICAL CENTER
PATCHOGUE, NY 11772
Phone number: 631-687-2953
Mailing Address
-- DAVID IRA JACKSON PA
PO BOX 13700-1378 BROOKHAVEN MEMORIAL HOSPITAL ER
PHILADELPHIA, PA 19191-1378
Phone number: 800-666-2455
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