Individual
SIEW JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 FRANKLIN TPKE STE 6A, WALDWICK, NJ 07463-1836
(201) 447-3603
Mailing address
669 BRIARCLIFF AVE, MAYWOOD, NJ 07607-1401
(201) 240-1703
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR13538400
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ14863400
NJ
Other
Enumeration date
05/03/2023
Last updated
03/12/2024
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