STARR SHALAE JACKSON

STATEN ISLAND, NY
NPI1578197588
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: NY  663663)
Additional Taxonomies163WG0000X Registered Nurse, General Practice
(Licence: NY  345211)
207Q00000X Family Medicine
(Licence: NY  345211)
208VP0014X Pain Medicine, Interventional Pain Medicine
(Licence: NY  345211)
Enumeration Date2020-02-28
Last Update Date2025-01-15
Business Address
Dr. STARR SHALAE JACKSON
2627 HYLAN BLVD
STATEN ISLAND, NY 10306-4344
Phone number: 646-533-0990
Mailing Address
Dr. STARR SHALAE JACKSON
333 LAKE AVE
STATEN ISLAND, NY 10303-2628
Phone number: