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JERREYLL T JACKSON M.D. P.C NPI 1235381732


NPI Information

NPI: 1235381732
Provider Name: JERREYLL T JACKSON M.D. P.C
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
20 E 46TH ST
NEW YORK, NY
ZIP 10017
Phone: (212) 889-1171
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JERREYLL T JACKSON M.D. P.C is an ophthalmology in New York, NY. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. JERREYLL T JACKSON M.D. P.C NPI is 1235381732. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

20 E 46TH ST
NEW YORK, NY
ZIP 10017-417
Phone: (212) 889-1171

The provider's authorized official is Jerreyll T Jackson .
The authorized official title is Provider and has the following contact phone number (212) 889-1171.

The enumeration date for this NPI number is 10/15/2008 and was last updated on 12/8/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmology237264NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10168092MEDICAIDNEW JERSEY
2521A51MEDICARE PINNEW YORK
3095704T64MEDICARE PINNEW JERSEY
4H37399MEDICARE UPINNEW YORK
502884251MEDICAIDNEW YORK
6095704CX9MEDICARE PINNEW JERSEY
72751471MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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