KIM B JACKSON NPI 1003415464

NPI Information

NPI: 1003415464
Provider Name: KIM B JACKSON
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
29 GLEN COVE AVE STE 212
GLEN COVE, NY
ZIP 11542
Phone: (516) 384-7670
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Kim B Jackson is a massage therapist in Glen Cove, NY. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Kim B Jackson NPI is 1003415464. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

29 GLEN COVE AVE STE 212
GLEN COVE, NY
ZIP 11542-831
Phone: (516) 384-7670

The enumeration date for this NPI number is 10/18/2020 and was last updated on 10/18/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		028858	NEW YORK	Yes

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: 11/14/2023

NPI Synchronization or Removal

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