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1487844973
LISA NICOLE JACKSON
JAMAICA, NY
NPI
1487844973
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207V00000X Obstetrics & Gynecology
(Licence: NY 60 245188)
Enumeration Date
2007-07-31
Last Update Date
2007-07-31
Business Address
-- LISA NICOLE JACKSON M.D.
89-06 135TH ST ROOM 6A
JAMAICA, NY 11418
Phone number: 718-206-6808
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Mailing Address
-- LISA NICOLE JACKSON M.D.
354 E 91ST ST APT 1805
NEW YORK, NY 10128-5354
Phone number: 312-213-6402
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