DANIEL JACKSON

SYRACUSE, NY
NPI1366975989
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: TX  U3550)
Additional Taxonomies2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: NY  300866)
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: WA  MD61477979)
Enumeration Date2017-04-10
Last Update Date2023-09-27
Business Address
DANIEL JACKSON
750 E ADAMS ST
SYRACUSE, NY 13210
Phone number: 315-464-5540
Mailing Address
DANIEL JACKSON
750 E ADAMS ST
SYRACUSE, NY 13210-2306
Phone number: