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1134988249
JACK BUCKANAVAGE
NEW YORK, NY
NPI
1134988249
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-19
Last Update Date
2024-03-19
Business Address
JACK BUCKANAVAGE
1468 MADISON AVE
NEW YORK, NY 10029-6508
Phone number: 212-241-6500
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Mailing Address
JACK BUCKANAVAGE
47 W PERIWINKLE LN
NEWARK, DE 19711-6211
Phone number: 302-357-6934
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