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1154461283
TRACY LETIA JACKSON
NEW YORK, NY
NPI
1154461283
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 006032-1)
Enumeration Date
2007-02-07
Last Update Date
2018-11-19
Business Address
Ms. TRACY LETIA JACKSON PA-C
215 W 125TH ST
NEW YORK, NY 10027-4426
Phone number: 212-939-3566
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Mailing Address
Ms. TRACY LETIA JACKSON PA-C
CITY COLLEGE OF NEW YORK 160 CONVENT AVENUE
NEW YORK, NY 10031
Phone number: 212-690-1000
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