Individual
DR. MICHAEL B. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
80 RIVER ST, 3D, HOBOKEN, NJ 07030-5626
(201) 244-7799
Mailing address
112 CHURCHILL RD, TENAFLY, NJ 07670-3120
(201) 588-9475
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
25MA08023100
NJ
2084P0800X
Psychiatry Physician
Primary
234087
NY
2084P0800X
Psychiatry Physician
25MA08023100
NJ
Other
Enumeration date
10/05/2006
Last updated
09/10/2019
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