Individual
DR. MARY MARGARET JACKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD OD
Contact information
Practice address
1101 ERIE BLVD EAST, SYRACUSE, NY 13210-3087
(315) 422-4412
(315) 422-4690
Mailing address
133 SUNRISE DR, SYRACUSE, NY 13205-2818
(315) 422-4412
(315) 422-4690
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
TUV0049071
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01100292
—
NY
Enumeration date
06/22/2006
Last updated
07/08/2007
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